Provider Demographics
NPI:1770507568
Name:CHASE, HEATHER SWAIN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:SWAIN
Last Name:CHASE
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 1:1001 CATHEDRAL ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5403
Mailing Address - Country:US
Mailing Address - Phone:410-837-2050
Mailing Address - Fax:410-837-7793
Practice Address - Street 1:1001 CATHEDRAL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5403
Practice Address - Country:US
Practice Address - Phone:410-837-2050
Practice Address - Fax:410-837-7793
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12927101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD132190100Medicaid
MDK802Medicare PIN
MD211850Medicare Oscar/Certification
MD132190100Medicaid
MD211819Medicare Oscar/Certification