Active NPI
Taylor Lake
- Professional Counselor
- District Heights, MD
National Provider Identifier
1366930760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC14912
- Practice address
- 6421 Atwood St
District Heights, MD 20747-1345 - Phone
- (301) 336-7600
- Fax
- (301) 499-2121
- NPI assigned
- May 1, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC14912 | MD | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
6421 Atwood St
District Heights, MD 20747-1345
Mailing address
6421 Atwood St
District Heights, MD 20747-1345
Phone (301) 336-7600
Other practice location 1
3814 12th St NE
Washington, DC 20017-2630
Phone (202) 569-1877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC14912 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Heights Family and Youth Services Bureau | Past | Accepting new patients | |
| District Heights Family & Youth Services Bureau | Professional | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Professional Counselor
- District Heights, MD
- NPI 1063827061
-
- Community/Behavioral Health Agency
- District Heights, MD
- NPI 1659822906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1366930760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6421 ATWOOD ST",
"city": "DISTRICT HEIGHTS",
"state": "MD",
"postal_code": "207471345",
"telephone_number": "301-336-7600",
"fax_number": "301-499-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6421 ATWOOD ST",
"city": "DISTRICT HEIGHTS",
"state": "MD",
"postal_code": "207471345",
"telephone_number": "301-336-7600",
"fax_number": "301-499-2121"
}
],
"practiceLocations": [
{
"address_1": "3814 12th St NE",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200172630",
"country_code": "US",
"telephone_number": "202-569-1877",
"fax_number": "202-204-5880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAKE",
"first_name": "TAYLOR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-01",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC14912",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in District Heights, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.