Provider Demographics
NPI:1275684607
Name:SOWBEL, LYNDA R (LCSW-C, BCD, ACSW)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:R
Last Name:SOWBEL
Suffix:
Gender:F
Credentials:LCSW-C, BCD, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 N BENTZ ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4913
Mailing Address - Country:US
Mailing Address - Phone:301-631-2936
Mailing Address - Fax:301-631-2937
Practice Address - Street 1:8812 INDIAN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-2332
Practice Address - Country:US
Practice Address - Phone:301-620-2902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD49081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ603Medicare ID - Type Unspecified