Provider Demographics
NPI:1033468806
Name:CLAYTON, KATRINA SHIRD (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:SHIRD
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:SHIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8600 LASALLE ROAD
Mailing Address - Street 2:CHESTER BUILDING SUITE 300
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286
Mailing Address - Country:US
Mailing Address - Phone:410-494-9212
Mailing Address - Fax:410-433-1249
Practice Address - Street 1:8600 LASALLE ROAD
Practice Address - Street 2:CHESTER BUILING SUITE 300
Practice Address - City:TOWON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-494-9212
Practice Address - Fax:410-494-9217
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD148441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical