Provider Demographics
NPI:1013437631
Name:JANKIEWICZ-REDENBAUGH, FALISHA MARIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:FALISHA
Middle Name:MARIE
Last Name:JANKIEWICZ-REDENBAUGH
Suffix:
Gender:F
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 1:2205 SEARLES RD
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-3216
Mailing Address - Country:US
Mailing Address - Phone:410-404-7713
Mailing Address - Fax:
Practice Address - Street 1:2205 SEARLES RD
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-3216
Practice Address - Country:US
Practice Address - Phone:410-404-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD147631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical