Provider Demographics
NPI:1811252745
Name:LEWIS, BEATRICE TRUBIN (MSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:BEATRICE
Middle Name:TRUBIN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SISTER PIERRE DR
Mailing Address - Street 2:SUITE 403
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7516
Mailing Address - Country:US
Mailing Address - Phone:410-823-6408
Mailing Address - Fax:443-279-0537
Practice Address - Street 1:9520 BERGER RD
Practice Address - Street 2:SUITE 203
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1501
Practice Address - Country:US
Practice Address - Phone:410-290-6940
Practice Address - Fax:443-279-0537
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD181171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical