Healthcare Provider Details

I. General information

NPI: 1487418943
Provider Name (Legal Business Name): BAILEY ISABELLA TAYLOR LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 DULANEY VALLEY RD STE 11
TOWSON MD
21204-2822
US

IV. Provider business mailing address

2049 E LOMBARD ST
BALTIMORE MD
21231-1924
US

V. Phone/Fax

Practice location:
  • Phone: 410-870-0490
  • Fax: 410-701-3777
Mailing address:
  • Phone: 803-381-5886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC17412
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: