Provider Demographics
NPI:1457086035
Name:HABERMAS, PATRICK (LMSW)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:HABERMAS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 EDMONDSON AVE APT A
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4472
Mailing Address - Country:US
Mailing Address - Phone:570-971-6923
Mailing Address - Fax:
Practice Address - Street 1:711 W 40TH ST STE 356
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2109
Practice Address - Country:US
Practice Address - Phone:443-918-5218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD287461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical