Provider Demographics
NPI:1255537460
Name:CLEMENTS, JAMES LAWSON (MSW, LCSW-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LAWSON
Last Name:CLEMENTS
Suffix:
Gender:M
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 1:16 BANGERT AVE
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9566
Mailing Address - Country:US
Mailing Address - Phone:410-256-6070
Mailing Address - Fax:
Practice Address - Street 1:16 BANGERT AVE
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9566
Practice Address - Country:US
Practice Address - Phone:410-256-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD015941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical