Provider Demographics
NPI:1326515651
Name:TAYLOR, SHERLEEN (ALC, MHC)
Entity Type:Individual
Prefix:
First Name:SHERLEEN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ALC, MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 4TH TER
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:AL
Mailing Address - Zip Code:35127-1726
Mailing Address - Country:US
Mailing Address - Phone:205-585-5074
Mailing Address - Fax:
Practice Address - Street 1:1957 HOOVER CT
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3622
Practice Address - Country:US
Practice Address - Phone:205-585-5074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2866A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6473186OtherDRIVER LICENSE