Provider Demographics
NPI:1689491219
Name:TOMLIN, LATASHA CHEREESE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:LATASHA
Middle Name:CHEREESE
Last Name:TOMLIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 DENTON DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2039
Mailing Address - Country:US
Mailing Address - Phone:240-544-5461
Mailing Address - Fax:
Practice Address - Street 1:7900 DENTON DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2039
Practice Address - Country:US
Practice Address - Phone:240-544-8461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500823771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical