Healthcare Provider Details

I. General information

NPI: 1104952068
Provider Name (Legal Business Name): KAREN MANDWELLE CAPLAN LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 01/28/2024
Certification Date: 01/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 W BELVEDERE AVE STE 508
BALTIMORE MD
21215-5232
US

IV. Provider business mailing address

2411 W BELVEDERE AVE STE 508
BALTIMORE MD
21215-5232
US

V. Phone/Fax

Practice location:
  • Phone: 443-847-1866
  • Fax: 410-601-9899
Mailing address:
  • Phone: 443-847-1866
  • Fax: 410-601-9899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13245
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13245
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: