Provider Demographics
NPI:1215309257
Name:TAYLOR, VELMA (LCPC)
Entity type:Individual
Prefix:
First Name:VELMA
Middle Name:
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 1:10701 JAVINS ST
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9416
Mailing Address - Country:US
Mailing Address - Phone:443-995-9835
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR STE 301
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4790
Practice Address - Country:US
Practice Address - Phone:443-995-9835
Practice Address - Fax:301-262-3696
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6694101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional