Provider Demographics
NPI:1932235959
Name:RISKIN, NANCY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:RISKIN
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 1:9 SCHILLING RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-8601
Mailing Address - Country:US
Mailing Address - Phone:410-560-1664
Mailing Address - Fax:410-771-9208
Practice Address - Street 1:9 SCHILLING RD STE 200
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-8601
Practice Address - Country:US
Practice Address - Phone:410-560-1664
Practice Address - Fax:410-771-9208
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11277MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD42762700Medicaid