Healthcare Provider Details

I. General information

NPI: 1417419821
Provider Name (Legal Business Name): LYNN ESKITE-TANT LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 N MAIN ST STE 301
BEL AIR MD
21014-8808
US

IV. Provider business mailing address

915 ARRAN RD
IDLEWYLDE MD
21239-1502
US

V. Phone/Fax

Practice location:
  • Phone: 443-567-7037
  • Fax:
Mailing address:
  • Phone: 717-514-3321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20138
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: