Provider Demographics
NPI:1114125515
Name:TAYLOR, LATRICIA S (LAPSW)
Entity Type:Individual
Prefix:MRS
First Name:LATRICIA
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LAPSW
Other - Prefix:MS
Other - First Name:LATRICIA
Other - Middle Name:S
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:7103 SHOW BOAT LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-2813
Mailing Address - Country:US
Mailing Address - Phone:901-591-6697
Mailing Address - Fax:901-266-5299
Practice Address - Street 1:1331 UNION AVE STE 1987
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3513
Practice Address - Country:US
Practice Address - Phone:901-729-1987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor