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General NPI Number Information
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NPI Number | 1336579762
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Entity Type | Individual
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Provider Name | FLOYD E TALIAFERRO IV LICSW, LCSWC
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Gender | Male
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Dates
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Enumeration Date | 11/21/2013
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 107 E 25TH ST
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City | BALTIMORE
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State | MD
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Zip | 21218-5213
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Country | US
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Telephone | 410-558-0032
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Fax | 410-366-2108
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Provider Business Mailing Address
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Address Line | 6133 MARLORA RD
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City | BALTIMORE
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State | MD
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Zip | 21239-1929
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Country | US
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Telephone | 410-262-7104
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 18615
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 18615
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50082004
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License Number State | DC
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