Healthcare Provider Details

I. General information

NPI: 1932863164
Provider Name (Legal Business Name): LAUREN ELIZABETH LINN LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 DOBBIN RD STE D
COLUMBIA MD
21045-4770
US

IV. Provider business mailing address

692 GLADSTONE AVE APT 1B
BALTIMORE MD
21210-2285
US

V. Phone/Fax

Practice location:
  • Phone: 410-730-2385
  • Fax:
Mailing address:
  • Phone: 410-591-8608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22809
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: