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Provider Information for 1942494463


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CARLISLE GREAVES LCSW-C


Sex: Male

NPI: 1942494463
Last Updated: 2022-01-12
Certification Date: 2022-01-12

Details

NameValue
NPI1942494463
Enumeration Date2007-08-28
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 10300 VISTA HOLLOW WAY
LANHAM, MD 20706-2895
United States

Phone: 240-210-6613 | Fax:
 
Primary Practice Address 10300 VISTA HOLLOW WAY
LANHAM, MD 20706-2895
United States

Phone: 240-210-6613 | Fax:
 
Secondary Practice Address(es)

9500 MEDICAL CENTER DR STE 420
LARGO, MD 20774-3716
United States

Phone: 410-245-9388 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalMD14236