Provider Demographics
NPI:1063413888
Name:WEBER, CATHERINE S (LCSWC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:S
Last Name:WEBER
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 ANNAPOLIS RD
Mailing Address - Street 2:STE A
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1328
Mailing Address - Country:US
Mailing Address - Phone:410-672-3921
Mailing Address - Fax:410-672-3921
Practice Address - Street 1:1223 ANNAPOLIS RD
Practice Address - Street 2:STE A
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1328
Practice Address - Country:US
Practice Address - Phone:410-672-3921
Practice Address - Fax:410-672-3921
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD017251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD295878OtherMAMSI
MDS071-0001OtherCAREFIRST BCBS, NCA
MD778611500Medicaid
MD0004604897OtherAETNA
MD100025844001OtherAMERICAN PSYCH SYSTEMS
MDQ420CSOtherCAREFIRST BCBS MD
MD048728000OtherMAGELLAN
MD096322OtherMHN
MD778611500Medicaid
MD295878OtherMAMSI