Provider Demographics
NPI:1396021499
Name:TAYLOR, AUBRA CELESTE (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:AUBRA
Middle Name:CELESTE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SW ADMIRAL WAY # 247
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2340
Mailing Address - Country:US
Mailing Address - Phone:206-414-1717
Mailing Address - Fax:206-694-2266
Practice Address - Street 1:411 UNIVERSITY ST STE 1236
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2515
Practice Address - Country:US
Practice Address - Phone:206-414-1717
Practice Address - Fax:206-694-2266
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60148865101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional