Provider Demographics
NPI:1144730102
Name:BARNEFY CHUKRUN, MICHAL (LGSW)
Entity type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:BARNEFY CHUKRUN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12251 TILDENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4161
Mailing Address - Country:US
Mailing Address - Phone:240-461-4752
Mailing Address - Fax:
Practice Address - Street 1:7801 OLD BRANCH AVE STE 212
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1642
Practice Address - Country:US
Practice Address - Phone:301-856-8516
Practice Address - Fax:301-856-8515
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22117104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker