Provider Demographics
NPI:1609881184
Name:STAWAS, LORRAINE PATRICIA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:PATRICIA
Last Name:STAWAS
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 1:218 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225-2910
Mailing Address - Country:US
Mailing Address - Phone:410-636-3665
Mailing Address - Fax:
Practice Address - Street 1:500 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4134
Practice Address - Country:US
Practice Address - Phone:410-788-0300
Practice Address - Fax:410-869-7244
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical