Provider Demographics
NPI:1457572653
Name:NAVE, JACQUELIN ANITA (LCSW-C)
Entity Type:Individual
Prefix:MISS
First Name:JACQUELIN
Middle Name:ANITA
Last Name:NAVE
Suffix:
Gender:F
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 1:729 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-4272
Mailing Address - Country:US
Mailing Address - Phone:410-751-7624
Mailing Address - Fax:
Practice Address - Street 1:288 E GREEN ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5410
Practice Address - Country:US
Practice Address - Phone:410-876-3007
Practice Address - Fax:410-876-5882
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD134231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical