Provider Demographics
NPI:1992939375
Name:NAZZARO, COURTNEY N (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:N
Last Name:NAZZARO
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 1:809 E BALTIMORE ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4733
Mailing Address - Country:US
Mailing Address - Phone:443-869-6512
Mailing Address - Fax:
Practice Address - Street 1:809 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4733
Practice Address - Country:US
Practice Address - Phone:443-869-6512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD162231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical