Healthcare Provider Details

I. General information

NPI: 1821869983
Provider Name (Legal Business Name): SHALEENA LEMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W 25TH ST
BALTIMORE MD
21218-5003
US

IV. Provider business mailing address

21 W 25TH ST
BALTIMORE MD
21218-5003
US

V. Phone/Fax

Practice location:
  • Phone: 410-366-1717
  • Fax:
Mailing address:
  • Phone: 410-366-1717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number28454
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: