Provider Demographics
NPI:1861764912
Name:VONENDT, JOAN
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:VONENDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:NONE
Other - Last Name:NONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:4128 HAYWARD AVE
Mailing Address - Street 2:STE W
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4340
Mailing Address - Country:US
Mailing Address - Phone:410-241-6317
Mailing Address - Fax:410-697-6055
Practice Address - Street 1:4128 HAYWARD AVE
Practice Address - Street 2:STE W
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4340
Practice Address - Country:US
Practice Address - Phone:410-327-6503
Practice Address - Fax:410-327-6825
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD020911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical