Provider Demographics
NPI:1578843520
Name:MOYER, TAYLOR NICHOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:NICHOLE
Last Name:MOYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 MERIT DR STE 450
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2294
Mailing Address - Country:US
Mailing Address - Phone:972-770-1032
Mailing Address - Fax:
Practice Address - Street 1:12221 MERIT DR STE 450
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2294
Practice Address - Country:US
Practice Address - Phone:972-770-1032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional