Provider Demographics
NPI:1508118456
Name:TAYLOR, LINDA MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 N 1890 W
Mailing Address - Street 2:STE 38B
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-1333
Mailing Address - Country:US
Mailing Address - Phone:385-626-9345
Mailing Address - Fax:
Practice Address - Street 1:719 N 1890 W STE 38B
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-1333
Practice Address - Country:US
Practice Address - Phone:385-626-9345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health