Provider Demographics
NPI:1629326426
Name:TAYLOR, PAIGE TAISON (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:TAISON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2396 FERGUSON AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-8036
Mailing Address - Country:US
Mailing Address - Phone:313-971-3039
Mailing Address - Fax:
Practice Address - Street 1:2040 N 22ND AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3152
Practice Address - Country:US
Practice Address - Phone:406-586-5511
Practice Address - Fax:406-586-4713
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2374101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional