Provider Demographics
NPI:1144866864
Name:TAYLOR D'AQUIN, AMBER LYNN (MA, LPC, LCDC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:TAYLOR D'AQUIN
Suffix:
Gender:F
Credentials:MA, LPC, LCDC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LYNN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2271 E CONTINENTAL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-9793
Mailing Address - Country:US
Mailing Address - Phone:817-898-1746
Mailing Address - Fax:817-898-1746
Practice Address - Street 1:2271 E CONTINENTAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9793
Practice Address - Country:US
Practice Address - Phone:817-898-1746
Practice Address - Fax:817-898-1746
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14494101YA0400X
TX91899101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)