Provider Demographics
NPI:1366688848
Name:TAYLOR, VICKI LEIGH (LMHC)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LEIGH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 FOURTH ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3312
Mailing Address - Country:US
Mailing Address - Phone:808-453-5950
Mailing Address - Fax:808-453-5966
Practice Address - Street 1:860 FOURTH ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3312
Practice Address - Country:US
Practice Address - Phone:808-453-5950
Practice Address - Fax:808-453-5966
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC 191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health