Provider Demographics
NPI:1144786302
Name:CHRISTINA L TAYLOR, LLC
Entity Type:Organization
Organization Name:CHRISTINA L TAYLOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:LOLITA
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LPCMH
Authorized Official - Phone:443-987-6557
Mailing Address - Street 1:2 HULLIHEN DR
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-2003
Mailing Address - Country:US
Mailing Address - Phone:240-481-4525
Mailing Address - Fax:410-793-1599
Practice Address - Street 1:282 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7311
Practice Address - Country:US
Practice Address - Phone:443-987-6557
Practice Address - Fax:410-793-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty