MEDICARE: MRS. SHAYLA LATEEFAH BULLOCK LCPC

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	101YP2500X	Professional Counselor	LC4067	MD

General Provider Information

NPI Number	:	1366003238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAYLA LATEEFAH BULLOCK LCPC

Provider Business Mailing Address
First Line	:	1773 MILL BRANCH DR
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-3414
Country	:	US
Telephone Number	:	301-256-8548
Fax Number	:

Provider Business Practice Location Address
First Line	:	1773 MILL BRANCH DR
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-3414
Country	:	US
Telephone Number	:	301-256-8548
Fax Number	:

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

Provider Enumeration Date	:	06/21/2019
Last Update Date	:	02/25/2026

Similar Medicare Providers

1952292773 — COMPASSIONATE INSIGHTS COUNSELING SERVICES LLC
Practice Location Address:

1773 MILL BRANCH DR
LAUREL, MD
20708-3414

Practice Phone: 301-821-6000
Practice Fax:

1184592842 — ABIBATU S KAMARA
Practice Location Address:

1715 MILL BRANCH DR
LAUREL, MD
20708-3414

Practice Phone: 301-300-6579
Practice Fax: 240-288-1045

1043188709 — AMYSVILLE HOME HEALTH, LLC
Practice Location Address:

1715 MILL BRANCH DR
LAUREL, MD
20708-3414

Practice Phone: 301-302-5128
Practice Fax: 240-288-1045

1922004613 — VIRTUA - MEMORIAL HOSPITAL OF BURLINGTON COUNTY, INC.
Practice Location Address:

523 FELLOWSHIP RD , STE 250
MOUNT LAUREL, NJ
08054-3414

Practice Phone: 856-581-7200
Practice Fax:

1346361128 — LAUREL EVALUATIONS
Practice Location Address:

523 FELLOWSHIP RD , SUITE 275
MOUNT LAUREL, NJ
08054-3414

Practice Phone: 856-235-7666
Practice Fax: 856-222-0427

1386054294 — VIRTUA HOME CARE -COMMUMITY NURSING SERVICES INC
Practice Location Address:

523 FELLOWSHIP RD , SUITE 250
MOUNT LAUREL, NJ
08054-3414

Practice Phone: 856-581-7214
Practice Fax:

Directions to “ MRS. SHAYLA LATEEFAH BULLOCK LCPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.