Healthcare Provider Details

I. General information

NPI: 1457638686
Provider Name (Legal Business Name): DONYALE WARNER LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONYALE BAKER LCSW-C

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 OLD EMMORTON ROAD SUITE 119
BEL AIR MD
21015
US

IV. Provider business mailing address

2227 OLD EMMORTON ROAD SUITE 119
BEL AIR MD
21015
US

V. Phone/Fax

Practice location:
  • Phone: 410-569-9497
  • Fax: 410-569-0094
Mailing address:
  • Phone: 410-569-9497
  • Fax: 410-569-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17536
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: