Provider Demographics
NPI:1609882547
Name:MAGGITTI, MEGHAN TAYLOR (LCPC)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:TAYLOR
Last Name:MAGGITTI
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 1:4256 CHAPEL GATE PL
Mailing Address - Street 2:
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017-1608
Mailing Address - Country:US
Mailing Address - Phone:202-747-4997
Mailing Address - Fax:
Practice Address - Street 1:4256 CHAPEL GATE PL
Practice Address - Street 2:
Practice Address - City:BELCAMP
Practice Address - State:MD
Practice Address - Zip Code:21017-1608
Practice Address - Country:US
Practice Address - Phone:202-747-4997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38895106H00000X
MDLC4962101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1609882547Medicaid