MEDICARE: TONYIA GODLOCK-KEMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	20553	MD

General Provider Information

NPI Number	:	1720521966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYIA GODLOCK-KEMP

Provider Business Mailing Address
First Line	:	2027 KELMORE RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-5604
Country	:	US
Telephone Number	:	410-262-6030
Fax Number	:

Provider Business Practice Location Address
First Line	:	4439 BELAIR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21206-6337
Country	:	US
Telephone Number	:	410-262-6030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	02/17/2026

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Directions to “ TONYIA GODLOCK-KEMP ” Practice Location

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