Healthcare Provider Details

I. General information

NPI: 1760999536
Provider Name (Legal Business Name): KATIE ELIZABETH HERN LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WADE AVE
CATONSVILLE MD
21228-4663
US

IV. Provider business mailing address

55 WADE AVE
CATONSVILLE MD
21228-4663
US

V. Phone/Fax

Practice location:
  • Phone: 410-402-7897
  • Fax:
Mailing address:
  • Phone: 410-402-7897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23006
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: