Provider Demographics
NPI:1740620475
Name:TAYLOR, FATIMA NEFERTITI (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:FATIMA
Middle Name:NEFERTITI
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MRS
Other - First Name:FATIMA
Other - Middle Name:NEFERTITI
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:9927 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-1803
Mailing Address - Country:US
Mailing Address - Phone:313-727-7609
Mailing Address - Fax:
Practice Address - Street 1:1498M REISTERSTOWN RD
Practice Address - Street 2:STE 269
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3842
Practice Address - Country:US
Practice Address - Phone:443-822-8343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical