Provider Demographics
NPI:1770880338
Name:PRATT, DARNELL LAWRENCE SR (LCSW-C)
Entity type:Individual
Prefix:
First Name:DARNELL
Middle Name:LAWRENCE
Last Name:PRATT
Suffix:SR
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 1:2721 WATER WHEEL CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1940
Mailing Address - Country:US
Mailing Address - Phone:410-984-6551
Mailing Address - Fax:
Practice Address - Street 1:10090 OLD COLUMBIA RD SUITE L260
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046
Practice Address - Country:US
Practice Address - Phone:443-259-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD099291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical