Individual provider · Type 1 NPI

Taelor Tristan Staton

Mental Health Counselor · Upper Marlboro, MD

NPI number 1194673004 Active

Practice location

10815 Devlin Dr
Upper Marlboro, MD 20772-4719

Call (240) 990-9718 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1194673004

Taelor Tristan Staton's National Provider Identifier is 1194673004, issued on Mar 17, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Upper Marlboro, MD. The record was last updated on Mar 17, 2026.