MEDICARE: LISA A EARLY LGPC

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	LC10301	MD

General Provider Information

NPI Number	:	1679051429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A EARLY LGPC

Provider Business Mailing Address
First Line	:	742 VILLAGER CIR
Second Line	:
City	:	DUNDALK
State	:	MD
Zip	:	21222-8802
Country	:	US
Telephone Number	:	240-888-0614
Fax Number	:

Provider Business Practice Location Address
First Line	:	900A S MAIN ST STE 105
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-5438
Country	:	US
Telephone Number	:	410-914-4012
Fax Number	:

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

Provider Enumeration Date	:	08/03/2018
Last Update Date	:	01/20/2026

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Directions to “ LISA A EARLY LGPC” Practice Location

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