Provider Demographics
NPI:1992840235
Name:INNERWORKSINC
Entity Type:Organization
Organization Name:INNERWORKSINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL-PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW-C
Authorized Official - Phone:301-862-2022
Mailing Address - Street 1:22325 GREENVIEW PKWY UNIT 1B
Mailing Address - Street 2:
Mailing Address - City:GREAT MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20634-3491
Mailing Address - Country:US
Mailing Address - Phone:301-862-2022
Mailing Address - Fax:
Practice Address - Street 1:22325 GREENVIEW PKWY
Practice Address - Street 2:UNIT 1B
Practice Address - City:GREAT MILLS
Practice Address - State:MD
Practice Address - Zip Code:20634-3491
Practice Address - Country:US
Practice Address - Phone:301-862-2022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17058251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD131PMedicare ID - Type UnspecifiedGROUP MENTAL HEALTH PRACT