Provider Demographics
NPI:1619684578
Name:XIMENEZ, MARIA EDURNE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:EDURNE
Last Name:XIMENEZ
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 1:325 S BOULDIN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2318
Mailing Address - Country:US
Mailing Address - Phone:240-404-8925
Mailing Address - Fax:
Practice Address - Street 1:5500 E LOMBARD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1731
Practice Address - Country:US
Practice Address - Phone:410-550-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD242831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical