Provider Demographics
NPI:1629210349
Name:BAGLI, KATE HATHAWAY (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:HATHAWAY
Last Name:BAGLI
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 1:7600 OSLER DR STE 404
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7703
Mailing Address - Country:US
Mailing Address - Phone:410-377-8823
Mailing Address - Fax:410-377-0006
Practice Address - Street 1:7600 OSLER DR STE 404
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-7703
Practice Address - Country:US
Practice Address - Phone:410-377-8823
Practice Address - Fax:410-377-0006
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09789172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker