Provider Demographics
NPI:1114442779
Name:LOFTIN, DORIS JEAN (LCSW-C)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:JEAN
Last Name:LOFTIN
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 1:3148 JEFFLAND RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3421
Mailing Address - Country:US
Mailing Address - Phone:443-286-0340
Mailing Address - Fax:
Practice Address - Street 1:3527 N ROLLING RD STE 10
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2256
Practice Address - Country:US
Practice Address - Phone:410-655-2738
Practice Address - Fax:410-655-2738
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD044431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical