Provider Demographics
NPI:1992088561
Name:TAYLOR, CORY A (MFT, CADC)
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MFT, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 BIG SKY DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1871
Mailing Address - Country:US
Mailing Address - Phone:775-848-7033
Mailing Address - Fax:
Practice Address - Street 1:6170 RIDGEVIEW CT STE C
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-6331
Practice Address - Country:US
Practice Address - Phone:775-848-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2023-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00163-C101YA0400X
NV01273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)