Provider Demographics
NPI:1164643821
Name:MCINTYRE, JANET CATLIN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:CATLIN
Last Name:MCINTYRE
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 1:106 MILFORD STREET
Mailing Address - Street 2:SUITE 501-B
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804
Mailing Address - Country:US
Mailing Address - Phone:410-651-4384
Mailing Address - Fax:
Practice Address - Street 1:106 MILFORD STREET
Practice Address - Street 2:SUITE 501-B
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804
Practice Address - Country:US
Practice Address - Phone:410-546-1692
Practice Address - Fax:410-548-9056
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD054871041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD241LMedicare ID - Type Unspecified