Provider Demographics
NPI:1144621384
Name:TAYLOR, TIMOTHY LEON (LPC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:LEON
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 MULBERRY ST.
Mailing Address - Street 2:PO BOX 250
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804
Mailing Address - Country:US
Mailing Address - Phone:325-646-9574
Mailing Address - Fax:325-646-7590
Practice Address - Street 1:408 MULBERRY ST.
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801
Practice Address - Country:US
Practice Address - Phone:325-646-9574
Practice Address - Fax:325-646-7590
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18914101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor