Provider Demographics
NPI:1427418029
Name:DEVER, ROGER II (LCSW-C (19689))
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:
Last Name:DEVER
Suffix:II
Gender:M
Credentials:LCSW-C (19689)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NORTH GREENE ST.
Mailing Address - Street 2:6TH FL
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1524
Mailing Address - Country:US
Mailing Address - Phone:410-605-7000
Mailing Address - Fax:410-605-7814
Practice Address - Street 1:10 NORTH GREENE ST.
Practice Address - Street 2:6TH FL
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-605-7000
Practice Address - Fax:410-605-7814
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19689104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker