Healthcare Provider Details

I. General information

NPI: 1326507237
Provider Name (Legal Business Name): TAYLOR WELLNESS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 BEDFORD AVE STE 114
PIKESVILLE MD
21208-3737
US

IV. Provider business mailing address

10999 RED RUN BLVD STE 205
OWINGS MILLS MD
21117-3249
US

V. Phone/Fax

Practice location:
  • Phone: 443-431-3875
  • Fax: 443-264-0426
Mailing address:
  • Phone: 443-431-3875
  • Fax: 443-264-0426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FATIMA TAYLOR
Title or Position: PRESIDENT AND CEO
Credential: LCSW-C
Phone: 443-431-3875