Provider Demographics
NPI:1922153964
Name:HOWARD REZNICK, LCSW --C, P. A.
Entity Type:Organization
Organization Name:HOWARD REZNICK, LCSW --C, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:REZNICK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW --C
Authorized Official - Phone:410-825-8729
Mailing Address - Street 1:28 ALLEGHENY AVE
Mailing Address - Street 2:SUITE 1208
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3909
Mailing Address - Country:US
Mailing Address - Phone:410-825-8729
Mailing Address - Fax:410-583-5553
Practice Address - Street 1:28 ALLEGHENY AVE
Practice Address - Street 2:SUITE 1208
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-3909
Practice Address - Country:US
Practice Address - Phone:410-825-8729
Practice Address - Fax:410-583-5553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD034231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD344M472FMedicare ID - Type Unspecified