Provider Demographics
NPI:1134727506
Name:RAY, MARIA ELEANOR NISSLEY (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELEANOR NISSLEY
Last Name:RAY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-3224
Mailing Address - Country:US
Mailing Address - Phone:434-981-9008
Mailing Address - Fax:
Practice Address - Street 1:906 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-3224
Practice Address - Country:US
Practice Address - Phone:434-981-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD264711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical