Provider Demographics
NPI:1417374042
Name:TAYLOR, ERICA LOWERY (MA, LCMHC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LOWERY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 QUILL CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-8378
Mailing Address - Country:US
Mailing Address - Phone:704-917-8989
Mailing Address - Fax:704-228-2631
Practice Address - Street 1:415 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052
Practice Address - Country:US
Practice Address - Phone:704-478-6093
Practice Address - Fax:704-973-9287
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20275101YA0400X
NC11105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)