Provider Demographics
NPI:1376880872
Name:ZDANCEWICZ, STANLEY CARL (LCSW C)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:CARL
Last Name:ZDANCEWICZ
Suffix:
Gender:M
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 1:2 ROLLING CROSSROADS
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-719-0086
Mailing Address - Fax:443-341-6218
Practice Address - Street 1:2 W. ROLLING CROSSROADS
Practice Address - Street 2:SUITE 209
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:443-562-4254
Practice Address - Fax:443-341-6218
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD185241041C0700X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251B00000XAgenciesCase Management