Provider Demographics
NPI:1518249531
Name:STRAMELLA, DEBORAH (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:STRAMELLA
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:IMHOF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:1406B CRAIN HWY S
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4099
Mailing Address - Country:US
Mailing Address - Phone:410-768-6088
Mailing Address - Fax:410-768-6444
Practice Address - Street 1:1406B CRAIN HWY S
Practice Address - Street 2:SUITE 206
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4099
Practice Address - Country:US
Practice Address - Phone:410-768-6088
Practice Address - Fax:410-768-6444
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14037104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD413568700Medicaid