Provider Demographics
NPI:1336244060
Name:CIMA, MARY W (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:W
Last Name:CIMA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MARGARET
Other - Last Name:WINTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW, LCSW-C
Mailing Address - Street 1:189 DUKE OF GLOUCESTER ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2519
Mailing Address - Country:US
Mailing Address - Phone:443-994-2738
Mailing Address - Fax:
Practice Address - Street 1:1831 FOREST DR STE D
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4430
Practice Address - Country:US
Practice Address - Phone:443-994-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500778541041C0700X, 1041S0200X
MD036531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD294006000Medicaid