Provider Demographics
NPI:1538521182
Name:MORENO, STEVEN (CSC-AD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:MORENO
Suffix:
Gender:M
Credentials:CSC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 BALTIMORE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2411
Mailing Address - Country:US
Mailing Address - Phone:301-896-6091
Mailing Address - Fax:301-881-7428
Practice Address - Street 1:6001 MONTROSE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4817
Practice Address - Country:US
Practice Address - Phone:301-896-6091
Practice Address - Fax:301-881-7428
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC0862101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)