Healthcare Provider Details

I. General information

NPI: 1215357694
Provider Name (Legal Business Name): CASSANDRA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 BEL AIR RD STE 102
BEL AIR MD
21014-4212
US

IV. Provider business mailing address

802 BEL AIR RD STE 102
BEL AIR MD
21014-4212
US

V. Phone/Fax

Practice location:
  • Phone: 443-760-3456
  • Fax: 443-371-2638
Mailing address:
  • Phone: 605-381-9706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34324
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: