Provider Demographics
NPI:1891565701
Name:TAYLOR, STEPHANIE ALEXIS (LCPC)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ALEXIS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 W TAYLOR ST # 482
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4623
Mailing Address - Country:US
Mailing Address - Phone:312-379-9790
Mailing Address - Fax:312-489-8308
Practice Address - Street 1:1440 W TAYLOR ST # 482
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4623
Practice Address - Country:US
Practice Address - Phone:312-379-9790
Practice Address - Fax:312-489-8308
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180015720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health