Provider Demographics
NPI:1508057860
Name:TAYLOR, ELIZABETH P (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:P
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 LAKELAND DR
Mailing Address - Street 2:SUITE P121
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4913
Mailing Address - Country:US
Mailing Address - Phone:601-209-4789
Mailing Address - Fax:866-772-1223
Practice Address - Street 1:1855 LAKELAND DR
Practice Address - Street 2:SUITE P121
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4913
Practice Address - Country:US
Practice Address - Phone:601-209-4789
Practice Address - Fax:866-772-1223
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0738101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor