Provider Demographics
NPI:1104374784
Name:TAYLOR, ASHELY CHARMAINE (LMHC)
Entity Type:Individual
Prefix:
First Name:ASHELY
Middle Name:CHARMAINE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 PARK CENTER DR STE 7
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5700
Mailing Address - Country:US
Mailing Address - Phone:407-730-3554
Mailing Address - Fax:
Practice Address - Street 1:2101 PARK CENTER DRIVE,
Practice Address - Street 2:SUITE 270
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835
Practice Address - Country:US
Practice Address - Phone:407-523-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FL16933101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health