Provider Demographics
NPI:1336021724
Name:TAYLORMADE COUNSELING & CONSULTING
Entity type:Organization
Organization Name:TAYLORMADE COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-500-7636
Mailing Address - Street 1:36330 HIDDEN SPRINGS RD STE E
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-5804
Mailing Address - Country:US
Mailing Address - Phone:951-500-7636
Mailing Address - Fax:
Practice Address - Street 1:36330 HIDDEN SPRINGS RD STE E
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-5804
Practice Address - Country:US
Practice Address - Phone:951-500-7636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAYLORMADE COUNSELING & CONSULTING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty