Provider Demographics
NPI:1083097513
Name:TAYLOR WYNKOOP COUNSELING
Entity Type:Organization
Organization Name:TAYLOR WYNKOOP COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:CARMICHAEL
Authorized Official - Last Name:WYNKOOP
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MA
Authorized Official - Phone:214-212-8660
Mailing Address - Street 1:1120 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4245
Mailing Address - Country:US
Mailing Address - Phone:214-212-8660
Mailing Address - Fax:
Practice Address - Street 1:1401 S TAFT AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-6942
Practice Address - Country:US
Practice Address - Phone:214-212-8660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011908251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health