Provider Demographics
NPI:1285990754
Name:EASLEY, TAYLOR D (LPC, LAC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:D
Last Name:EASLEY
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:D
Other - Last Name:WIGINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LAC
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4597
Mailing Address - Country:US
Mailing Address - Phone:303-436-5711
Mailing Address - Fax:303-602-4560
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4597
Practice Address - Country:US
Practice Address - Phone:303-436-5711
Practice Address - Fax:303-602-4560
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012615101YP2500X
171M00000X
COACD.0000526101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator