Provider Demographics
NPI:1134336514
Name:DELOVITCH, JOAN E (MS, LCMFT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:DELOVITCH
Suffix:
Gender:F
Credentials:MS, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15312 SPENCERVILLE CT
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1666
Mailing Address - Country:US
Mailing Address - Phone:301-421-9100
Mailing Address - Fax:
Practice Address - Street 1:15312 SPENCERVILLE CT
Practice Address - Street 2:SUITE 301
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1666
Practice Address - Country:US
Practice Address - Phone:301-421-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist