Provider Demographics
NPI:1629300462
Name:DOWD, CECIL SR (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:
Last Name:DOWD
Suffix:SR
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CECIL
Other - Middle Name:
Other - Last Name:DOWD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:2902 EAST JOPPA ROAD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234
Mailing Address - Country:US
Mailing Address - Phone:410-870-0562
Mailing Address - Fax:
Practice Address - Street 1:2902 EAST JOPPA ROAD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234
Practice Address - Country:US
Practice Address - Phone:410-870-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01645101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01645Medicaid