Provider Demographics
NPI:1477855807
Name:GILDEN, DEVERA EILEEN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DEVERA
Middle Name:EILEEN
Last Name:GILDEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SEMINARY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4756
Mailing Address - Country:US
Mailing Address - Phone:443-562-6880
Mailing Address - Fax:410-339-5437
Practice Address - Street 1:5209 YORK ROAD, SUITE B12
Practice Address - Street 2:WOMEN'S GROWTH CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212
Practice Address - Country:US
Practice Address - Phone:410-532-2476
Practice Address - Fax:410-532-2747
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08281104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker