Provider Demographics
NPI:1114611746
Name:MESSERLY, TAYLOR (PLPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:MESSERLY
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 S RIVER BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4659
Mailing Address - Country:US
Mailing Address - Phone:816-768-0090
Mailing Address - Fax:816-912-1739
Practice Address - Street 1:4429 S RIVER BLVD STE B
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4659
Practice Address - Country:US
Practice Address - Phone:816-768-0090
Practice Address - Fax:816-912-1739
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty