Provider Demographics
NPI:1548941966
Name:TERRELL, ROSALIND LAVERN (LCSW-C)
Entity type:Individual
Prefix:
First Name:ROSALIND
Middle Name:LAVERN
Last Name:TERRELL
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:ROSALIND
Other - Middle Name:
Other - Last Name:TERRELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:4413 FALLS BRIDGE DR APT C
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1373
Mailing Address - Country:US
Mailing Address - Phone:443-326-3452
Mailing Address - Fax:
Practice Address - Street 1:4413 FALLS BRIDGE DR APT C
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1373
Practice Address - Country:US
Practice Address - Phone:443-326-3452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD142681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical