Provider Demographics
NPI:1639880131
Name:FARLEY, TAYLOR (LPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:FARLEY
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 1:1712 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2939
Mailing Address - Country:US
Mailing Address - Phone:580-430-8111
Mailing Address - Fax:844-269-9952
Practice Address - Street 1:1712 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2939
Practice Address - Country:US
Practice Address - Phone:580-430-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11187101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional