Healthcare Provider Details

I. General information

NPI: 1053296236
Provider Name (Legal Business Name): TASHA ROANE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W PRATT ST
BALTIMORE MD
21201-1023
US

IV. Provider business mailing address

13 SILVER BIRCH CT
OWINGS MILLS MD
21117-5101
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-2207
  • Fax:
Mailing address:
  • Phone: 410-746-7037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29370
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: