Provider Demographics
NPI:1255599874
Name:LOVE, JAYNE MIGDAL (JAYNE LOVE LCSW-C)
Entity type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:MIGDAL
Last Name:LOVE
Suffix:
Gender:F
Credentials:JAYNE LOVE LCSW-C
Other - Prefix:MS
Other - First Name:JAYNE
Other - Middle Name:MIGDAL
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JAYNE LOVE LCSW-C
Mailing Address - Street 1:7101 TRAVERTINE DR
Mailing Address - Street 2:#202
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2120
Mailing Address - Country:US
Mailing Address - Phone:410-580-1949
Mailing Address - Fax:410-580-0040
Practice Address - Street 1:7101 TRAVERTINE DR
Practice Address - Street 2:#202
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2120
Practice Address - Country:US
Practice Address - Phone:410-580-1949
Practice Address - Fax:410-580-0040
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11363C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical