Provider Demographics
NPI:1194288431
Name:EPPERSON, TAWNY MEAGAN (PHD, LCPC, CT)
Entity type:Individual
Prefix:DR
First Name:TAWNY
Middle Name:MEAGAN
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:PHD, LCPC, CT
Other - Prefix:
Other - First Name:TAWNY
Other - Middle Name:MEAGAN
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LCPC, CT
Mailing Address - Street 1:4940 EASTERN AVENUE
Mailing Address - Street 2:COMMUNITY PSYCHIATRY PROGRAM
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2735
Mailing Address - Country:US
Mailing Address - Phone:410-550-0067
Mailing Address - Fax:
Practice Address - Street 1:5500 E LOMBARD STREET
Practice Address - Street 2:COMMUNITY PSYCHIATRY, CHILD MOBILE TREATMENT SERVICES
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-550-0067
Practice Address - Fax:410-550-8288
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health