Provider Demographics
NPI:1366490922
Name:TAYLOR, MARC P (LPC)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:P
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 W GRACE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4911
Mailing Address - Country:US
Mailing Address - Phone:804-738-2505
Mailing Address - Fax:804-783-2514
Practice Address - Street 1:517 W GRACE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4911
Practice Address - Country:US
Practice Address - Phone:804-738-2505
Practice Address - Fax:804-783-2514
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002371101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor