Provider Demographics
NPI:1750734687
Name:CAVALIERE, STEPHANIE P (LCSW-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:P
Last Name:CAVALIERE
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 1:27 MONTROSE MANOR CT APT H
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5014
Mailing Address - Country:US
Mailing Address - Phone:631-942-6480
Mailing Address - Fax:
Practice Address - Street 1:2225 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5778
Practice Address - Country:US
Practice Address - Phone:410-453-9553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099476104100000X
MD25180104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY099476OtherTHE UNIVERSITY OF STATE OF NEW YORK OFFICE OF THE PROFESSIONS
MD25180OtherBOARD OF SOCIAL WORK EXAMINERS