Provider Demographics
NPI:1124042965
Name:CHAKMAKIAN, ELISABETH GARRETT (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:GARRETT
Last Name:CHAKMAKIAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8182 LARK BROWN RD
Mailing Address - Street 2:STE 201
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6428
Mailing Address - Country:US
Mailing Address - Phone:410-274-7612
Mailing Address - Fax:410-799-5576
Practice Address - Street 1:8182 LARK BROWN RD
Practice Address - Street 2:STE 201
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6428
Practice Address - Country:US
Practice Address - Phone:410-274-7612
Practice Address - Fax:410-799-5576
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical