Provider Demographics
NPI:1679686422
Name:HAERIAN, KATHY ANN (LCSW C)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:ANN
Last Name:HAERIAN
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:A
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:744 DULANEY VALLEY RD STE 12
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5132
Mailing Address - Country:US
Mailing Address - Phone:410-245-1304
Mailing Address - Fax:443-269-0206
Practice Address - Street 1:744 DULANEY VALLEY RD STE 12
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-5132
Practice Address - Country:US
Practice Address - Phone:410-245-1304
Practice Address - Fax:443-269-0206
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical