Provider Demographics
NPI:1467076745
Name:DARE, MARCALENE NICOLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARCALENE
Middle Name:NICOLE
Last Name:DARE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4559
Mailing Address - Country:US
Mailing Address - Phone:667-600-2110
Mailing Address - Fax:667-600-4064
Practice Address - Street 1:308 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4559
Practice Address - Country:US
Practice Address - Phone:667-600-2110
Practice Address - Fax:667-600-4064
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD249811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical