Provider Demographics
NPI:1851062152
Name:PAYTON, TAMEKA L (PHD, LGPC)
Entity Type:Individual
Prefix:DR
First Name:TAMEKA
Middle Name:L
Last Name:PAYTON
Suffix:
Gender:F
Credentials:PHD, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-1705
Mailing Address - Country:US
Mailing Address - Phone:410-776-9612
Mailing Address - Fax:
Practice Address - Street 1:807 E BALTIMORE ST STE BB
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5389
Practice Address - Country:US
Practice Address - Phone:443-327-8292
Practice Address - Fax:443-360-3767
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-26
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11869101YM0800X
1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health