Provider Demographics
NPI:1962622761
Name:CALVANO, SHARON T (LCSWC)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:T
Last Name:CALVANO
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 CLIPPER PARK RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211
Mailing Address - Country:US
Mailing Address - Phone:410-889-8966
Mailing Address - Fax:410-889-8971
Practice Address - Street 1:2002 CLIPPER PARK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211
Practice Address - Country:US
Practice Address - Phone:410-889-8966
Practice Address - Fax:410-889-8971
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD093941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
568540OtherVALUE OPTIONS
MD65081301OtherCAREFIRST BCBS