Provider Demographics
NPI:1932648466
Name:TAYLOR, KAREN (BS, CSC-AD)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BS, CSC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 ENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3715
Mailing Address - Country:US
Mailing Address - Phone:410-675-7500
Mailing Address - Fax:
Practice Address - Street 1:424 ENFIELD RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3715
Practice Address - Country:US
Practice Address - Phone:410-675-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC2031101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)