Provider Demographics
NPI:1093156259
Name:TAWATA, KALELEI H (LCSW-C)
Entity type:Individual
Prefix:
First Name:KALELEI
Middle Name:H
Last Name:TAWATA
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 1:629 MARPETE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-1740
Mailing Address - Country:US
Mailing Address - Phone:410-294-9612
Mailing Address - Fax:
Practice Address - Street 1:250 ENGLAR RD STE 10
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-2927
Practice Address - Country:US
Practice Address - Phone:410-294-9612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD147721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical