MEDICARE: EVELYN MAYE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	699	MD
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAC11043	DC
3	101YP2500X	Professional Counselor	115023	DC
4	101YP2500X	Professional Counselor	PRC14450	DC

General Provider Information

NPI Number	:	1265854392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN MAYE

Provider Business Mailing Address
First Line	:	1629 K ST NW
Second Line	:	#300
City	:	WASHINGTON
State	:	DC
Zip	:	20006-1602
Country	:	US
Telephone Number	:	301-899-2210
Fax Number	:	888-205-3238

Provider Business Practice Location Address
First Line	:	9440 MARLBORO AVE STE 330
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3659
Country	:	US
Telephone Number	:	301-899-2210
Fax Number	:	888-205-3238

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2014
Last Update Date	:	02/28/2023

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Directions to “ EVELYN MAYE ” Practice Location

Language	Start Address	Practice Location

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