Provider Demographics
NPI:1669957668
Name:BAPTISTE, GISELA DE LA PENA (LCPC)
Entity type:Individual
Prefix:
First Name:GISELA
Middle Name:DE LA PENA
Last Name:BAPTISTE
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 1:10447 FAIR OAKS
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4143
Mailing Address - Country:US
Mailing Address - Phone:410-992-2224
Mailing Address - Fax:
Practice Address - Street 1:8640 GUILFORD RD STE 251
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2665
Practice Address - Country:US
Practice Address - Phone:419-992-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760727069OtherNPI II