Provider Demographics
NPI:1275566572
Name:RAFERT, NANCY (MSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:RAFERT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:948 DEVON DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7738
Mailing Address - Country:US
Mailing Address - Phone:410-398-4222
Mailing Address - Fax:410-398-8678
Practice Address - Street 1:215 NORTH ST STE D
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5505
Practice Address - Country:US
Practice Address - Phone:410-398-4222
Practice Address - Fax:410-398-4222
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD087441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
388SMedicare ID - Type Unspecified
Q32094Medicare UPIN