Provider Demographics
NPI:1144086810
Name:TAYLOR, COLBY A (LCPC)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:A
Last Name:TAYLOR
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 1:11941 BOURNEFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7821
Mailing Address - Country:US
Mailing Address - Phone:877-552-6672
Mailing Address - Fax:224-306-1878
Practice Address - Street 1:11941 BOURNEFIELD WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7821
Practice Address - Country:US
Practice Address - Phone:877-552-6672
Practice Address - Fax:224-306-1878
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC14583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional