Provider Demographics
NPI:1609298058
Name:GORENA, JOAN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:GORENA
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15619 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1452
Mailing Address - Country:US
Mailing Address - Phone:301-642-5379
Mailing Address - Fax:
Practice Address - Street 1:2000 DENNIS AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4136
Practice Address - Country:US
Practice Address - Phone:240-777-1053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-19
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD188441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical