Provider Demographics
NPI:1528365004
Name:TAYLOR, AMY R (LMHC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 NE 27TH ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-2234
Mailing Address - Country:US
Mailing Address - Phone:206-972-6415
Mailing Address - Fax:
Practice Address - Street 1:1900 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4606
Practice Address - Country:US
Practice Address - Phone:206-902-4228
Practice Address - Fax:866-451-0126
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60192480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60192480OtherMENTAL HEALTH COUNSELOR LICENSE