Active NPI
Christa Marvenko-Athas, LCSW-C
- Clinical Social Worker
- Towson, MD
National Provider Identifier
1194980177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11258
- Practice address
- 305 W Chesapeake Ave
Suite L12
Towson, MD 21204-4421 - Phone
- (410) 367-1029
- NPI assigned
- Jul 19, 2008
- Last updated
- Jul 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11258 | MD | Primary |
Addresses
Primary practice location
305 W Chesapeake Ave
Suite L12
Towson, MD 21204-4421
Mailing address
305 W Chesapeake Ave
Suite L12
Towson, MD 21204-4421
Phone (410) 367-1029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11258 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216425600000",
"number": "1194980177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 W CHESAPEAKE AVE",
"address_2": "SUITE L12",
"city": "TOWSON",
"state": "MD",
"postal_code": "212044421",
"telephone_number": "410-367-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 W CHESAPEAKE AVE",
"address_2": "SUITE L12",
"city": "TOWSON",
"state": "MD",
"postal_code": "212044421",
"telephone_number": "410-367-1029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARVENKO-ATHAS",
"first_name": "CHRISTA",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-19",
"last_updated": "2008-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "11258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Towson, MD
- Tarah Lea Martin, LCSW-C
- Thomas Roger Martin Jr., MS ATC
- William Forrest Martin III, D.D.S.
- Rafaelina Martinez, P.A.
- Steven Mineo Martinez, MD
- Evelyn Linda Marx, L.C.S.W.-C., PH.D.
- Mary Jo Fishburn, M.D., PA
- Mary Teddy Wray DDS Dba Towson Extreme Smiles
- Maryland Aesthetic and Reconstructive Ambulatory Surgical Center LLC
- Maryland CVS Pharmacy LLC (CVS Pharmacy 04129)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.