Healthcare Provider Details

I. General information

NPI: 1124837141
Provider Name (Legal Business Name): MICHAEL LLOYD TAYLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 WISCONSIN AVE NW STE 402
WASHINGTON DC
20015-2055
US

IV. Provider business mailing address

12805 ATLANTIC AVE
ROCKVILLE MD
20851-1913
US

V. Phone/Fax

Practice location:
  • Phone: 202-237-7000
  • Fax: 202-237-0017
Mailing address:
  • Phone: 301-421-8031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: