Provider Demographics
NPI:1790393809
Name:WHITAKER-CAMPBELL, CHERI MICHELE (LMSW)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:MICHELE
Last Name:WHITAKER-CAMPBELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 PEARTREE WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4356
Mailing Address - Country:US
Mailing Address - Phone:410-406-7852
Mailing Address - Fax:
Practice Address - Street 1:2340 EUTAW PL
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3911
Practice Address - Country:US
Practice Address - Phone:410-701-2408
Practice Address - Fax:410-406-7852
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker