Provider Demographics
NPI:1598113037
Name:VAN BUSKIRK, TAYLOR FRANCIS (LPC, LCAS, CSI, NCC)
Entity Type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:FRANCIS
Last Name:VAN BUSKIRK
Suffix:
Gender:M
Credentials:LPC, LCAS, CSI, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 BLUE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-7270
Mailing Address - Country:US
Mailing Address - Phone:828-682-2111
Mailing Address - Fax:828-682-9323
Practice Address - Street 1:72 BLUE RIDGE LN
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-7270
Practice Address - Country:US
Practice Address - Phone:828-682-2111
Practice Address - Fax:828-682-9323
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC-12461101YP2500X
NCLCAS-22571101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional