Provider Demographics
NPI:1588950190
Name:TAYLOR, STEPHANIE LABELLE (LMHC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LABELLE
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 1:280 N MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1814
Mailing Address - Country:US
Mailing Address - Phone:413-351-7276
Mailing Address - Fax:
Practice Address - Street 1:280 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-1814
Practice Address - Country:US
Practice Address - Phone:413-351-7276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA82-3560325OtherMASSACHUSETTS