Provider Demographics
NPI:1760861785
Name:CROSS, JANEEN (DSW, MSW, MBA)
Entity type:Individual
Prefix:DR
First Name:JANEEN
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:DSW, MSW, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 FIDLER LANE
Mailing Address - Street 2:APT. 1100
Mailing Address - City:SILVER SPRING
Mailing Address - State:MA
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:267-252-6653
Mailing Address - Fax:
Practice Address - Street 1:8701 GEORGIA AVE STE 406
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3713
Practice Address - Country:US
Practice Address - Phone:267-252-6653
Practice Address - Fax:301-495-2726
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500813491041C0700X
PACW0181641041C0700X
MD227541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical