Provider Demographics
NPI:1730399288
Name:CARROLL, MARIA M (MSSW, PHD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:M
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MSSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 WALTHER BLVD.
Mailing Address - Street 2:#1229
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5723
Mailing Address - Country:US
Mailing Address - Phone:410-661-5785
Mailing Address - Fax:
Practice Address - Street 1:8810 WALTHER BLVD.
Practice Address - Street 2:# 1229
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-5723
Practice Address - Country:US
Practice Address - Phone:410-661-5785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE00005361041C0700X
MD025721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical