Provider Demographics
NPI:1316404205
Name:PISANO, TAYLOR MARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:MARIE
Last Name:PISANO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3033
Mailing Address - Country:US
Mailing Address - Phone:203-245-5645
Mailing Address - Fax:203-245-5648
Practice Address - Street 1:10 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3033
Practice Address - Country:US
Practice Address - Phone:203-245-5645
Practice Address - Fax:203-245-5648
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2062106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist