Provider Demographics
NPI:1144561580
Name:PROUT, MARIA JOY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JOY
Last Name:PROUT
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 1:5187 OLD SOLOMONS ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:LOTHIAN
Mailing Address - State:MD
Mailing Address - Zip Code:20711-2207
Mailing Address - Country:US
Mailing Address - Phone:443-949-6050
Mailing Address - Fax:
Practice Address - Street 1:5187 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:LOTHIAN
Practice Address - State:MD
Practice Address - Zip Code:20711-2207
Practice Address - Country:US
Practice Address - Phone:443-949-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD164541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical