Provider Demographics
NPI:1598985533
Name:TAYLOR, DEBRA LYNN (CACIII, LPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CACIII, LPC
Other - Prefix:
Other - First Name:LYN
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1455 CRITERION ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-7701
Mailing Address - Country:US
Mailing Address - Phone:970-874-5692
Mailing Address - Fax:
Practice Address - Street 1:107 W 11TH ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1811
Practice Address - Country:US
Practice Address - Phone:970-399-2927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2674101YA0400X
CO3590101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2674OtherCERTIFIED ADDICTIONS COUN
CO3590OtherLICENSED PROF. COUNSELOR