Provider Demographics
NPI:1376396127
Name:PAGE, NEATRICE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:NEATRICE
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MRS
Other - First Name:NEATRICE
Other - Middle Name:
Other - Last Name:NESMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:2418 WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-6230
Mailing Address - Country:US
Mailing Address - Phone:443-219-8286
Mailing Address - Fax:
Practice Address - Street 1:2418 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-6230
Practice Address - Country:US
Practice Address - Phone:443-219-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD224221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical