Provider Demographics
NPI:1962038745
Name:TAYLOR, CAITIE (MS, LMHC-T)
Entity type:Individual
Prefix:
First Name:CAITIE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, LMHC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 AURORA AVE STE 103E
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-6338
Mailing Address - Country:US
Mailing Address - Phone:515-401-6886
Mailing Address - Fax:515-401-5237
Practice Address - Street 1:6200 AURORA AVE STE 103E
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-6338
Practice Address - Country:US
Practice Address - Phone:515-401-6886
Practice Address - Fax:515-401-5237
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA099144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health