Healthcare Provider Details

I. General information

NPI: 1851062152
Provider Name (Legal Business Name): TAMEKA L PAYTON PHD, LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2021
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N CHARLES ST STE 1900
BALTIMORE MD
21201-3727
US

IV. Provider business mailing address

1 N CHARLES ST STE 1900
BALTIMORE MD
21201-3727
US

V. Phone/Fax

Practice location:
  • Phone: 443-327-8292
  • Fax:
Mailing address:
  • Phone: 443-327-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP11869
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: