Individual provider Active NPI

Tanya Todman-Taylor, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1780954636
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17625 Issued in MD
Practice address
2510 Saint Paul St
Baltimore, MD 21218-4760
Phone
(410) 558-0032
Fax
(410) 366-2108
NPI assigned
Jan 10, 2012
Last updated
Jan 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17625 MD Primary

Addresses

Primary practice location

2510 Saint Paul St
Baltimore, MD 21218-4760

Mailing address

6133 Marlora Rd
Baltimore, MD 21239-1929
Phone (410) 262-7104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120329000470 MD Practitioner - Clinical Social Worker 1557521473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On-Time Medical Group IncGroup PAC ID 7618417627, 6 clinicians

Practice addresses (Care Compare)

9846 Liberty Rd
Randallstown, MD 21133-2007
Phone (410) 754-4343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17625MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
On-Time Medical Group Inc Current Accepting new patients
On-Time Medical Group Inc CurrentSince Jun 5, 2025 Accepting new patients
On-Time Medical Group Inc CurrentSince Jun 5, 2025 Accepting new patients

Locations

9846 Liberty Rd
Randallstown, MD 21133
Phone (410) 754-4343

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1780954636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6133 MARLORA RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212391929",
            "telephone_number": "410-262-7104",
            "fax_number": "410-366-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184760",
            "telephone_number": "410-558-0032",
            "fax_number": "410-366-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODMAN-TAYLOR",
        "first_name": "TANYA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.