Provider Demographics
NPI:1467066092
Name:WIEGARD, CIARA (LMSW)
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:WIEGARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1829 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-302-8302
Mailing Address - Fax:
Practice Address - Street 1:1829 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6320
Practice Address - Country:US
Practice Address - Phone:443-449-5604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26262104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker