Provider Demographics
NPI:1679514699
Name:MARAVI, JOSEPH ARI (LCSWC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ARI
Last Name:MARAVI
Suffix:
Gender:M
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SISTER PIERRE DRIVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-823-6408
Mailing Address - Fax:443-279-0537
Practice Address - Street 1:7130 MINSTREL WAY
Practice Address - Street 2:SUITE 212
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:410-290-6940
Practice Address - Fax:410-290-9763
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD073831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
164178OtherVAL
226283OtherKAIS
252450OtherCOMP GROUP #
253548OtherCOMP
395960OtherMAMS
K452OtherBSDC GROUP #
2131680OtherCIGN
2131680OtherCIGN GROUP #
292852Other292852
0012OtherBSDC
PVPB123514OtherAPS
150NK978OtherMBMD
54264405OtherBSMD
PVPB123514OtherAPS GROUP #
226283OtherKAIS GROUP #
705BPSOtherBSMD GROUP #
2131680OtherCIGN
395960OtherMAMS