Provider Demographics
NPI:1053482927
Name:TAYLOR, LAURA M (MS, LCMHCS, EMDR-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, LCMHCS, EMDR-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4154 MENDENHALL OAKS PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8426
Mailing Address - Country:US
Mailing Address - Phone:336-884-9510
Mailing Address - Fax:336-884-9518
Practice Address - Street 1:4154 MENDENHALL OAKS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8426
Practice Address - Country:US
Practice Address - Phone:336-884-9510
Practice Address - Fax:336-884-9518
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4739101YM0800X
NCS4739101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102142Medicaid