=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225997521
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAISHA CHALENE LOCKHART
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2026
-----------------------------------------------------
Last Update Date | 01/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8141 TELEGRAPH RD # R
-----------------------------------------------------
City | SEVERN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21144-3256
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-296-6038
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7513 BLUE SUN DR
-----------------------------------------------------
City | GLEN BURNIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21060-8789
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-306-8798
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------