Provider Demographics
NPI:1982375515
Name:POPE, TASHA NICOLE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:NICOLE
Last Name:POPE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 E NORTHERN PKWY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-1542
Mailing Address - Country:US
Mailing Address - Phone:443-864-7641
Mailing Address - Fax:
Practice Address - Street 1:3013 MONTEBELLO TER
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-3311
Practice Address - Country:US
Practice Address - Phone:443-449-6532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23549104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker