Provider Demographics
NPI:1417531062
Name:TAYLOR, PAISLEY (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:PAISLEY
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 OFERRELL ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7625
Mailing Address - Country:US
Mailing Address - Phone:363-515-0554
Mailing Address - Fax:
Practice Address - Street 1:311 OFERRELL ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7625
Practice Address - Country:US
Practice Address - Phone:336-515-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16447101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health