Provider Demographics
NPI:1548283971
Name:CANDELARIO, NERIZA S (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:NERIZA
Middle Name:S
Last Name:CANDELARIO
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 1:1501 DIVISION STREET
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-3121
Mailing Address - Country:US
Mailing Address - Phone:410-383-8300
Mailing Address - Fax:410-728-4732
Practice Address - Street 1:2401 LIBERTY HEIGHTS AVE.
Practice Address - Street 2:SUITE 111
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215
Practice Address - Country:US
Practice Address - Phone:410-383-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical