Provider Demographics
NPI:1619028727
Name:PRELLER, RITA MARIE (LCSW C)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:MARIE
Last Name:PRELLER
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 1:16829 YORK RD
Mailing Address - Street 2:PO BOX 544
Mailing Address - City:MONKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21111-1020
Mailing Address - Country:US
Mailing Address - Phone:410-329-2028
Mailing Address - Fax:410-343-1272
Practice Address - Street 1:2 STONE RIDGE CT
Practice Address - Street 2:#31
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-1339
Practice Address - Country:US
Practice Address - Phone:410-828-0655
Practice Address - Fax:410-828-0655
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical