Provider Demographics
NPI:1487679494
Name:STANTON, ANDREW K (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:K
Last Name:STANTON
Suffix:
Gender:M
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9031 BILLOW ROW
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2343
Mailing Address - Country:US
Mailing Address - Phone:410-707-1267
Mailing Address - Fax:
Practice Address - Street 1:8182 LARK BROWN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6428
Practice Address - Country:US
Practice Address - Phone:410-707-1267
Practice Address - Fax:410-799-5576
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD088311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical