Provider Demographics
NPI:1720250095
Name:KIRKLAND, SANDRA G (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:G
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 SOUTH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2627
Mailing Address - Country:US
Mailing Address - Phone:410-703-8523
Mailing Address - Fax:410-923-1094
Practice Address - Street 1:150 SOUTH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2627
Practice Address - Country:US
Practice Address - Phone:410-703-8523
Practice Address - Fax:410-923-1094
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD112821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical