Provider Demographics
NPI:1588370209
Name:TAYLOR, JOHN H (CADC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 CORPORATE CT STE 1
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-3158
Mailing Address - Country:US
Mailing Address - Phone:610-481-0444
Mailing Address - Fax:610-448-1907
Practice Address - Street 1:2970 CORPORATE CT STE 1
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-3158
Practice Address - Country:US
Practice Address - Phone:610-481-0444
Practice Address - Fax:610-448-1907
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)