Provider Demographics
NPI:1144785718
Name:TAYLOR, TAKIYA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TAKIYA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 INDEPENDENCE PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5216
Mailing Address - Country:US
Mailing Address - Phone:757-453-4485
Mailing Address - Fax:757-463-0573
Practice Address - Street 1:638 INDEPENDENCE PKWY STE 270
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5216
Practice Address - Country:US
Practice Address - Phone:757-453-4485
Practice Address - Fax:757-463-0573
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008079101YP2500X
VA0718000447101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)