Provider Demographics
NPI:1093930257
Name:LLOYD, EVELYN WHITE (RN,MS,CS-P)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:WHITE
Last Name:LLOYD
Suffix:
Gender:F
Credentials:RN,MS,CS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5533 SUFFIELD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2773
Mailing Address - Country:US
Mailing Address - Phone:410-730-1148
Mailing Address - Fax:
Practice Address - Street 1:5074 DORSEY HALL DR
Practice Address - Street 2:STE 104
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7792
Practice Address - Country:US
Practice Address - Phone:301-596-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO38679101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD100410700Medicaid
MD100410700Medicaid