Provider Demographics
NPI:1912213307
Name:MCNITT, CAROL DIANE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:DIANE
Last Name:MCNITT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:DM
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:423 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-1610
Mailing Address - Country:US
Mailing Address - Phone:240-472-0617
Mailing Address - Fax:
Practice Address - Street 1:2635 RIVA RD STE 108
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7430
Practice Address - Country:US
Practice Address - Phone:104-573-9000
Practice Address - Fax:410-573-9001
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical