Provider Demographics
NPI:1366740664
Name:GREY, TARYN NICOLE (LCPC, M ED)
Entity type:Individual
Prefix:MRS
First Name:TARYN
Middle Name:NICOLE
Last Name:GREY
Suffix:
Gender:F
Credentials:LCPC, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 ROCK SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2631
Mailing Address - Country:US
Mailing Address - Phone:410-838-2493
Mailing Address - Fax:410-838-2597
Practice Address - Street 1:2018 ROCK SPRING RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2631
Practice Address - Country:US
Practice Address - Phone:410-838-2493
Practice Address - Fax:410-838-2597
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3843101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor