Provider Demographics
NPI:1104507680
Name:VORWERCK, JOHN STEVEN (CAC-AD MARYLAND)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:STEVEN
Last Name:VORWERCK
Suffix:
Gender:M
Credentials:CAC-AD MARYLAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5055
Mailing Address - Country:US
Mailing Address - Phone:410-857-8448
Mailing Address - Fax:410-857-0239
Practice Address - Street 1:77 E MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5055
Practice Address - Country:US
Practice Address - Phone:410-857-8448
Practice Address - Fax:410-857-0239
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC1083101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)