Provider Demographics
NPI:1194212688
Name:DOUTHITT, TAYLOR E (LCPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:E
Last Name:DOUTHITT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12502 WILLOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6491
Mailing Address - Country:US
Mailing Address - Phone:240-964-8585
Mailing Address - Fax:240-964-8586
Practice Address - Street 1:12502 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6491
Practice Address - Country:US
Practice Address - Phone:240-964-8585
Practice Address - Fax:240-964-8586
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8516101YP2500X
MDLC10108101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional