Provider Demographics
NPI:1396810248
Name:LOVE, VINCENT JAMES (LCSW-C)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:JAMES
Last Name:LOVE
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6819
Mailing Address - Country:US
Mailing Address - Phone:410-938-3464
Mailing Address - Fax:410-938-3410
Practice Address - Street 1:9030 STATE ROUTE 108
Practice Address - Street 2:OAKLAND CENTER
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1951
Practice Address - Country:US
Practice Address - Phone:410-740-1901
Practice Address - Fax:410-740-2503
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical