Provider Demographics
NPI:1295483667
Name:WERNECK
Entity type:Organization
Organization Name:WERNECK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNECK
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-292-2384
Mailing Address - Street 1:7506 OVERVIEW TER
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4486
Mailing Address - Country:US
Mailing Address - Phone:410-292-2384
Mailing Address - Fax:
Practice Address - Street 1:7506 OVERVIEW TER
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-4486
Practice Address - Country:US
Practice Address - Phone:410-292-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty