Provider Demographics
NPI:1356907844
Name:DEVLIN, PETER (LGSW/LMSW)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:LGSW/LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 WABASH AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6775
Mailing Address - Country:US
Mailing Address - Phone:718-285-1731
Mailing Address - Fax:
Practice Address - Street 1:6305 IVY LN STE 101
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-6326
Practice Address - Country:US
Practice Address - Phone:301-235-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD22714OtherLGSW