Provider Demographics
NPI:1902382138
Name:MCALLEN, MARY BAETZ (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:BAETZ
Last Name:MCALLEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 SISTER PIERRE DR STE 403
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7536
Mailing Address - Country:US
Mailing Address - Phone:401-823-6408
Mailing Address - Fax:443-279-0537
Practice Address - Street 1:120 SISTER PIERRE DR STE 403
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-823-6408
Practice Address - Fax:443-279-0537
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD098791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical