Provider Demographics
NPI:1124336102
Name:LOVE, EMILY ALLISON (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ALLISON
Last Name:LOVE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ALLISON
Other - Last Name:SERPICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:5750 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3930
Mailing Address - Country:US
Mailing Address - Phone:410-843-7384
Mailing Address - Fax:
Practice Address - Street 1:5750 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3930
Practice Address - Country:US
Practice Address - Phone:410-843-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD097991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical