Basic Information
| Provider Information | |||||||||
| NPI: | 1033411814 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ACS | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | ELENA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6355 WOODSIDE CT | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210461071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103817171 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5755 CEDAR LN | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107407890 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2010 | ||||||||
| LastUpdateDate: | 11/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 09439 | MD | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.