Provider Demographics
NPI:1558834291
Name:STANCOVICH, MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:STANCOVICH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:EVE
Other - Middle Name:MARIE
Other - Last Name:STANCOVICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:1000 LIBERTY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7936
Mailing Address - Country:US
Mailing Address - Phone:443-527-2335
Mailing Address - Fax:
Practice Address - Street 1:247 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5228
Practice Address - Country:US
Practice Address - Phone:410-305-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8772101YM0800X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health