Provider Demographics
NPI:1205910411
Name:MARKS, DEBORAH BOSS (MSW, LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:BOSS
Last Name:MARKS
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CELTIS CT
Mailing Address - Street 2:
Mailing Address - City:FORK
Mailing Address - State:MD
Mailing Address - Zip Code:21051-9729
Mailing Address - Country:US
Mailing Address - Phone:410-592-5880
Mailing Address - Fax:410-367-8158
Practice Address - Street 1:1702 SOUTH RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4504
Practice Address - Country:US
Practice Address - Phone:410-367-9105
Practice Address - Fax:410-367-8158
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD047981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical