Provider Demographics
NPI:1174882153
Name:TANCEMORE, ERIN RAE (LCSW-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:RAE
Last Name:TANCEMORE
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 1:7000 GOLDEN RING RD UNIT 9564
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-7603
Mailing Address - Country:US
Mailing Address - Phone:410-497-5173
Mailing Address - Fax:
Practice Address - Street 1:2408 CULLUM RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6523
Practice Address - Country:US
Practice Address - Phone:443-758-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD148191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical