Provider Demographics
NPI:1629812391
Name:EHRHARDT, MICHAELA POOLE (LMSW)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:POOLE
Last Name:EHRHARDT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 KANAWHA AVE
Mailing Address - Street 2:
Mailing Address - City:POINT OF ROCKS
Mailing Address - State:MD
Mailing Address - Zip Code:21777-2031
Mailing Address - Country:US
Mailing Address - Phone:301-606-6343
Mailing Address - Fax:
Practice Address - Street 1:226 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6205
Practice Address - Country:US
Practice Address - Phone:301-663-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD31672104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker