Individual provider · Type 1 NPI

Jessica Tawanda Fauntleroy, LCSW-C

Clinical Social Worker · Baltimore, MD

NPI number 1255840609 Active

Practice location

1501 Division St
Baltimore, MD 21217-3121

Mailing address

4017 Cranston Ave
Baltimore, MD 21229-1908

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X15292 (MD)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1255840609

Jessica Tawanda Fauntleroy, LCSW-C's National Provider Identifier is 1255840609, issued on Sep 28, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Baltimore, MD. The record was last updated on Sep 28, 2017.