Provider Demographics
NPI:1467668913
Name:GUMM, TERRI D (LCSW)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:D
Last Name:GUMM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 THOMAS JOHNSON DR
Mailing Address - Street 2:STE 202L
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4564
Mailing Address - Country:US
Mailing Address - Phone:301-733-0330
Mailing Address - Fax:301-733-4038
Practice Address - Street 1:184 THOMAS JOHNSON DR
Practice Address - Street 2:STE 202L
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4564
Practice Address - Country:US
Practice Address - Phone:240-644-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical