Provider Demographics
NPI:1750260626
Name:GORHAM, LATONYA (LMSW)
Entity type:Individual
Prefix:
First Name:LATONYA
Middle Name:
Last Name:GORHAM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1701
Mailing Address - Country:US
Mailing Address - Phone:410-493-4173
Mailing Address - Fax:
Practice Address - Street 1:1005 NORTHPOINT BLVD STE 707
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3402
Practice Address - Country:US
Practice Address - Phone:410-878-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26454104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty