Provider Demographics
NPI:1235701228
Name:LOMANGINO, KRISTIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:LOMANGINO
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 1:4990 MERCANTILE RD UNIT 43913
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-8540
Mailing Address - Country:US
Mailing Address - Phone:443-353-7511
Mailing Address - Fax:
Practice Address - Street 1:4132 E JOPPA RD STE 110-1335
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-2272
Practice Address - Country:US
Practice Address - Phone:516-749-9344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-11
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD263761041C0700X
NY0973461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical