Provider Demographics
NPI:1225228372
Name:TAYLOR, LAFREDIA F (LPC/RN)
Entity Type:Individual
Prefix:MS
First Name:LAFREDIA
Middle Name:F
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 4334
Mailing Address - Street 2:THERAPEUTIC HEALTH SERVICES
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36204
Mailing Address - Country:US
Mailing Address - Phone:256-239-7766
Mailing Address - Fax:256-237-1748
Practice Address - Street 1:1621 LEIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36202
Practice Address - Country:US
Practice Address - Phone:256-239-7766
Practice Address - Fax:256-237-1748
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2546101Y00000X, 101YP2500X
AL1-091481163W00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice