Provider Demographics
NPI:1568921377
Name:TAYLOR, ELIZABETH JOANN (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 SILVER FALLS ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-8396
Mailing Address - Country:US
Mailing Address - Phone:773-240-0999
Mailing Address - Fax:
Practice Address - Street 1:440 W BOUGHTON RD STE 200E
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-4510
Practice Address - Country:US
Practice Address - Phone:773-240-0999
Practice Address - Fax:630-597-9263
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012224101YP2500X
IL180.012852101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional