Provider Demographics
NPI:1487207338
Name:GUY VAN DEVANDER, BRITTANY (LMSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:GUY VAN DEVANDER
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 1:789 SUNNYFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21225-3364
Mailing Address - Country:US
Mailing Address - Phone:443-842-0449
Mailing Address - Fax:
Practice Address - Street 1:1101 N POINT BLVD STE 128
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3417
Practice Address - Country:US
Practice Address - Phone:443-231-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22875104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker