Provider Demographics
NPI:1326644881
Name:TAYLOR, JESSICA M (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 BERWYN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1809
Mailing Address - Country:US
Mailing Address - Phone:510-334-7319
Mailing Address - Fax:
Practice Address - Street 1:161 S BOYD ST STE 100
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3574
Practice Address - Country:US
Practice Address - Phone:407-392-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23861101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health