Provider Demographics
NPI:1154850337
Name:ALLEN, MARIA JOSE JERONIMO (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSE JERONIMO
Last Name:ALLEN
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 1:5291 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5511
Mailing Address - Country:US
Mailing Address - Phone:301-708-9064
Mailing Address - Fax:
Practice Address - Street 1:5291 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-5511
Practice Address - Country:US
Practice Address - Phone:301-708-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker