Provider Demographics
NPI:1194046987
Name:TAYLOR, CHUN SHIN (LCPC)
Entity type:Individual
Prefix:
First Name:CHUN
Middle Name:SHIN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9610 DONNAN CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5972
Mailing Address - Country:US
Mailing Address - Phone:240-547-9934
Mailing Address - Fax:
Practice Address - Street 1:3355 ST.JOHNS LANE
Practice Address - Street 2:SUITE J
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:240-547-9934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional