Provider Demographics
NPI:1427111061
Name:TAYLOR, PATRICIA LYNN (LPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:TRISHA
Other - Middle Name:L
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3625 MANCHACA RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6631
Mailing Address - Country:US
Mailing Address - Phone:512-922-4000
Mailing Address - Fax:
Practice Address - Street 1:3625 MANCHACA RD
Practice Address - Street 2:SUITE 103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6631
Practice Address - Country:US
Practice Address - Phone:512-922-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17488101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor