Provider Demographics
NPI:1588401269
Name:CALVERT, HARRY SAMUEL (LGPC)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:SAMUEL
Last Name:CALVERT
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 ROMNEY CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1265
Mailing Address - Country:US
Mailing Address - Phone:301-785-3618
Mailing Address - Fax:
Practice Address - Street 1:14815 MANOR RD
Practice Address - Street 2:
Practice Address - City:MONKTON
Practice Address - State:MD
Practice Address - Zip Code:21111-2400
Practice Address - Country:US
Practice Address - Phone:410-205-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15291101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional