Provider Demographics
NPI:1043071038
Name:BAPTISTE, PHILIP (LCPC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:BAPTISTE
Suffix:
Gender:M
Credentials:LCPC CANDIDATE
Other - Prefix:DR
Other - First Name:PHILIP
Other - Middle Name:
Other - Last Name:BAPTISTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMIN, MA, CMHC,
Mailing Address - Street 1:12815 FERNWOOD TURN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2502
Mailing Address - Country:US
Mailing Address - Phone:303-437-2981
Mailing Address - Fax:
Practice Address - Street 1:8115 MAPLE LAWN BLVD STE 350
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2683
Practice Address - Country:US
Practice Address - Phone:301-960-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral