Provider Demographics
NPI:1629559109
Name:WELLS, TAYLOR MARIE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:MARIE
Last Name:WELLS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 9TH ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2020
Mailing Address - Country:US
Mailing Address - Phone:304-526-2049
Mailing Address - Fax:304-526-2638
Practice Address - Street 1:517 9TH ST STE 2B
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2020
Practice Address - Country:US
Practice Address - Phone:304-526-2049
Practice Address - Fax:304-526-2638
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2374101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health