Provider Demographics
NPI:1699443671
Name:TAYLOR, LAURA (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 OAK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-4906
Mailing Address - Country:US
Mailing Address - Phone:817-688-3136
Mailing Address - Fax:
Practice Address - Street 1:420 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-2845
Practice Address - Country:US
Practice Address - Phone:940-532-1129
Practice Address - Fax:940-301-3797
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82880101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82880OtherTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELOR