Provider Demographics
NPI:1427449792
Name:WALDT, DARLENE (LCSW-C)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:WALDT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8133 BULLNECK RD
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-6030
Mailing Address - Country:US
Mailing Address - Phone:443-799-1009
Mailing Address - Fax:
Practice Address - Street 1:8133 BULLNECK RD
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-6030
Practice Address - Country:US
Practice Address - Phone:443-799-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD194361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical