Provider Demographics
NPI:1689349060
Name:SICARD, STEPHANIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SICARD
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 1:7520 STANDISH PL STE 190
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2847
Mailing Address - Country:US
Mailing Address - Phone:301-525-2029
Mailing Address - Fax:
Practice Address - Street 1:7520 STANDISH PL STE 190
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2847
Practice Address - Country:US
Practice Address - Phone:301-525-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical