MRS. SHAYLA LATEEFAH BULLOCK LCPC
NPI 1366003238
Counselor - Professional in Laurel, MD
Active since June 21, 2019
About Mrs. Shayla Lateefah Bullock Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. SHAYLA LATEEFAH BULLOCK LCPC (NPI 1366003238) is an individual professional provider in Laurel, Maryland, licensed in Maryland (LC4067) and active in the NPI registry since June 2019.
NPPES Registry Identity
NPI1366003238
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. SHAYLA LATEEFAH BULLOCKCredential: LCPC
Location Address1773 MILL BRANCH DRLaurel, MD 20708-3414
Mailing Address1773 Mill Branch DrLaurel, MD 20708-3414 · (301) 256-8548
Phone(301) 256-8548
Sole ProprietorYes
Enumeration DateJune 21, 2019
Last NPPES UpdateFebruary 25, 2026
NPPES CertifiedFebruary 25, 2026
✔ NPI 1366003238 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MD · LC4067
1773 MILL BRANCH DR, Laurel, MD 20708
Other Names 1
Former Name (1)Miss Shayla L Duncan
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Professional)
1773 MILL BRANCH DR
LAUREL, MD 20708
LAUREL, MD 20708
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366003238, enumerated as an "individual" on June 21, 2019.
The provider is located at 1773 MILL BRANCH DR LAUREL, MD 20708 and the phone number is (301) 256-8548.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
