Provider Demographics
NPI:1326813262
Name:HORNER, NATASHA (LCPC)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HORNER
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 1:5044 DORSEY HALL DR STE 204
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7500
Mailing Address - Country:US
Mailing Address - Phone:410-884-9200
Mailing Address - Fax:
Practice Address - Street 1:5044 DORSEY HALL DR STE 204
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7500
Practice Address - Country:US
Practice Address - Phone:410-884-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC14519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty