Provider Demographics
NPI:1942865498
Name:CLAYBROOKS, MARGO STARR (LCPC)
Entity Type:Individual
Prefix:
First Name:MARGO
Middle Name:STARR
Last Name:CLAYBROOKS
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 1:5603 LIBERTY TER
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MD
Mailing Address - Zip Code:21225-3540
Mailing Address - Country:US
Mailing Address - Phone:410-269-3351
Mailing Address - Fax:
Practice Address - Street 1:14201 LAUREL PARK DR STE 221
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:410-269-3351
Practice Address - Fax:667-200-1820
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10493101YM0800X
MDLGP8690101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty