Provider Demographics
NPI:1467648063
Name:KURCZ, MARY CAROLINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CAROLINE
Last Name:KURCZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4032 WILDWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5002
Mailing Address - Country:US
Mailing Address - Phone:410-461-0512
Mailing Address - Fax:410-461-0512
Practice Address - Street 1:5022 DORSEY HALL DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7829
Practice Address - Country:US
Practice Address - Phone:410-461-0512
Practice Address - Fax:410-461-0512
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical