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General NPI Number Information
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NPI Number | 1952737454
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Entity Type | Individual
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Provider Name | EBONI D TAYLOR-TUE LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 155 LOG CANOE CIR
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City | STEVENSVILLE
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State | MD
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Zip | 21666-2127
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Country | US
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Telephone | 410-604-0226
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Fax | 410-822-5569
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Provider Business Mailing Address
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Address Line | 221 DUTCHESS RD
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City | CHESTERTOWN
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State | MD
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Zip | 21620-2211
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Country | US
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Telephone | 443-480-3588
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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 | 19155
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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 | 19155
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License Number State | MD
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