Provider Demographics
NPI:1619372588
Name:LOCKERMAN, CHANA (LCSW-C, LICSW)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:LOCKERMAN
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BLAIR MILL RD
Mailing Address - Street 2:UNIT 1209
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4862
Mailing Address - Country:US
Mailing Address - Phone:202-277-0609
Mailing Address - Fax:
Practice Address - Street 1:11904 DARNESTOWN RD STE F
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-3202
Practice Address - Country:US
Practice Address - Phone:202-277-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD165111041C0700X
DCLC500796871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical