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General NPI Number Information
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NPI Number | 1225499320
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Entity Type | Individual
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Provider Name | MATTHEW DANIEL TAYLOR M.S., LCPC
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Gender | Male
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 04/01/2017
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Provider Practice Location Address
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Address Line | 25 EAST ELLENDALE STREET
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City | BEL AIR
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State | MD
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Zip | 21014-2610
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Country | US
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Telephone | 410-638-5168
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Fax |
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Provider Business Mailing Address
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Address Line | 305 TERRYSYDE CT B
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City | FALLSTON
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State | MD
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Zip | 21047-2610
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Country | US
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Telephone | 410-218-7302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC7617
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License Number State | MD
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