Provider Demographics
NPI:1255656039
Name:TAYLOR, NIEFA ANTOINETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:NIEFA
Middle Name:ANTOINETTE
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 1:165 BURKE ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3463
Mailing Address - Country:US
Mailing Address - Phone:404-563-5189
Mailing Address - Fax:678-623-3748
Practice Address - Street 1:165 BURKE ST
Practice Address - Street 2:SUITE 109
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3463
Practice Address - Country:US
Practice Address - Phone:404-563-5189
Practice Address - Fax:678-623-3748
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 006345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional