Provider Demographics
NPI:1477926590
Name:TAYLOR, TASHA M (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:M
Other - Last Name:MACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7037 PAINT ROCK LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6913
Mailing Address - Country:US
Mailing Address - Phone:919-247-7134
Mailing Address - Fax:
Practice Address - Street 1:2609 ATLANTIC AVENUE
Practice Address - Street 2:SUITE 111-C
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604
Practice Address - Country:US
Practice Address - Phone:919-247-7134
Practice Address - Fax:919-247-7134
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist