Basic Information
Provider Information
NPI: 1366781916
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROSS TAYLOR
FirstName: KAREN
MiddleName: ANN
NamePrefix: MS.
NameSuffix:  
Credential: LCSW-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 421 FALLSWAY
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212024800
CountryCode: US
TelephoneNumber: 4108375533
FaxNumber: 4108372168
Practice Location
Address1: 421 FALLSWAY
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212024800
CountryCode: US
TelephoneNumber: 4108375533
FaxNumber: 4108372168
Other Information
ProviderEnumerationDate: 02/01/2013
LastUpdateDate: 02/01/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X18507MDY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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