Provider Demographics
NPI:1952455982
Name:REZNICK, HOWARD ALEC (LCSW -- C)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:ALEC
Last Name:REZNICK
Suffix:
Gender:M
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 1:28 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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD034231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD344MMedicare ID - Type Unspecified