Provider Demographics
NPI:1588228910
Name:BALTIMORE, CARA ASHLEY RAQUEL (LMSW)
Entity type:Individual
Prefix:MS
First Name:CARA
Middle Name:ASHLEY RAQUEL
Last Name:BALTIMORE
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 1:1829 REISTERSTOWN RD STE 350
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-7126
Mailing Address - Country:US
Mailing Address - Phone:443-202-1377
Mailing Address - Fax:
Practice Address - Street 1:90 PAINTERS MILL RD STE 136
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3610
Practice Address - Country:US
Practice Address - Phone:443-202-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104100000X
MD240511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker