Provider Demographics
NPI:1669352241
Name:CROSLIN, EVERETT SHEMAR
Entity type:Individual
Prefix:
First Name:EVERETT
Middle Name:SHEMAR
Last Name:CROSLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 CHARLES VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2106
Mailing Address - Country:US
Mailing Address - Phone:443-570-0841
Mailing Address - Fax:
Practice Address - Street 1:1135 CHARLES VIEW WAY
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2106
Practice Address - Country:US
Practice Address - Phone:443-570-0841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician