Provider Demographics
NPI:1477323756
Name:TAYLOR-SMITH, AMY (LCMHCA)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:TAYLOR-SMITH
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ROLLING HILL RD STE 110B
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8856
Mailing Address - Country:US
Mailing Address - Phone:704-360-2464
Mailing Address - Fax:980-701-0073
Practice Address - Street 1:121 ROLLING HILL RD STE 110B
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8856
Practice Address - Country:US
Practice Address - Phone:704-360-2464
Practice Address - Fax:980-701-0073
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19523101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health