Provider Demographics
NPI:1144554064
Name:MCCAULEY, ANNE VIRGINIA (MSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:VIRGINIA
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 LONG CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-2770
Mailing Address - Country:US
Mailing Address - Phone:410-924-8254
Mailing Address - Fax:410-924-8254
Practice Address - Street 1:111 N WEST ST STE H
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2760
Practice Address - Country:US
Practice Address - Phone:443-906-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD185401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD609550004Medicaid
MD609550002Medicaid
MD609550001Medicaid