Provider Demographics
NPI:1356162408
Name:RIZZO, MARK FRANCIS (LMSW)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:FRANCIS
Last Name:RIZZO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6802 MCCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7200
Mailing Address - Country:US
Mailing Address - Phone:410-444-3800
Mailing Address - Fax:
Practice Address - Street 1:6802 MCCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-7200
Practice Address - Country:US
Practice Address - Phone:410-444-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29365104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker