Provider Demographics
NPI:1275361586
Name:KEARNEY, GLORIA GAIL (LMSW)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:GAIL
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 PHILADELPHIA WAY
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4412
Mailing Address - Country:US
Mailing Address - Phone:301-429-6191
Mailing Address - Fax:
Practice Address - Street 1:5100 PHILADELPHIA WAY
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4412
Practice Address - Country:US
Practice Address - Phone:301-429-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD268941041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool