Provider Demographics
NPI:1376949560
Name:GAMBOA SWEET, CATHARINE CARROLL
Entity Type:Individual
Prefix:
First Name:CATHARINE
Middle Name:CARROLL
Last Name:GAMBOA SWEET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHARINE
Other - Middle Name:CARROLL
Other - Last Name:GAMBOA SWEET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:16220 FREDERICK RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-4039
Mailing Address - Country:US
Mailing Address - Phone:301-978-9750
Mailing Address - Fax:
Practice Address - Street 1:16220 FREDERICK RD
Practice Address - Street 2:SUITE 502
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4039
Practice Address - Country:US
Practice Address - Phone:301-978-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD066431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical