Provider Demographics
NPI:1093597213
Name:TAYLOR, LAURA JEAN (LPC, LPCMH)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JEAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S PENNSVILLE AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CARNEYS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08069-2936
Mailing Address - Country:US
Mailing Address - Phone:856-299-3200
Mailing Address - Fax:856-485-8579
Practice Address - Street 1:500 S PENNSVILLE AUBURN RD
Practice Address - Street 2:
Practice Address - City:CARNEYS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08069-2936
Practice Address - Country:US
Practice Address - Phone:856-299-3200
Practice Address - Fax:856-485-8579
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00893600101Y00000X
DEPC-0000969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor