Provider Demographics
NPI:1578284089
Name:CRIARIS, KATRINA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARIE
Last Name:CRIARIS
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 1:746 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5745
Mailing Address - Country:US
Mailing Address - Phone:609-273-5150
Mailing Address - Fax:
Practice Address - Street 1:3000 MANCHESTER RD # B
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-1850
Practice Address - Country:US
Practice Address - Phone:410-861-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28325104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker