Provider Demographics
NPI:1417385253
Name:KOELSCH, JANET MARIE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MARIE
Last Name:KOELSCH
Suffix:
Gender:F
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 1:6520 WINGFLASH LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4641
Mailing Address - Country:US
Mailing Address - Phone:410-245-5316
Mailing Address - Fax:410-309-1797
Practice Address - Street 1:6520 WINGFLASH LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4641
Practice Address - Country:US
Practice Address - Phone:410-245-5316
Practice Address - Fax:410-309-1797
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2015-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD110941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical