Provider Demographics
NPI:1215693189
Name:DECKARD, TAYLOR NICOLE (MED, LPC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NICOLE
Last Name:DECKARD
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:NICOLE
Other - Last Name:GOLDSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LPC
Mailing Address - Street 1:7120 W I 40 STE 410
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2500
Mailing Address - Country:US
Mailing Address - Phone:806-670-6162
Mailing Address - Fax:
Practice Address - Street 1:7120 W I 40 STE 410
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2500
Practice Address - Country:US
Practice Address - Phone:806-318-8172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional