Ezersky, Stacey R
Ezersky, Stacey R is an sole proprietor health care provider with primary practice located at 3635 Old Court Rd Ste 305 , Pikesville MD 21208-3907. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ezersky, Stacey R can be contacted via phone (443) 898-8308.Contact Information
Primary practice address
3635 Old Court Rd Ste 305
Pikesville MD 21208-3907
Phone: (443) 898-8308
Fax: (443) 327-4753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 13400 | Maryland |
Profile Details
| NPI number | 1689709800 |
|---|---|
| LBN Legal business name | Ezersky, Stacey R |
| Credentials | LCSW C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Jan 22nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689709800 | NPPES |
| Maryland | MEDICAID | 412244500 |
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