Provider Demographics
NPI:1801426770
Name:LANDING, KAYLAN NICOLE (LCSWC)
Entity type:Individual
Prefix:
First Name:KAYLAN
Middle Name:NICOLE
Last Name:LANDING
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:KAYLAN
Other - Middle Name:JAMES
Other - Last Name:CRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-3224
Mailing Address - Country:US
Mailing Address - Phone:240-405-6392
Mailing Address - Fax:
Practice Address - Street 1:3301 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-3224
Practice Address - Country:US
Practice Address - Phone:240-405-6392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD248181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical