Provider Demographics
NPI:1679091060
Name:LOVE TAYLOR, CARRIE MAE (LMFT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:MAE
Last Name:LOVE TAYLOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N BEECH ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1115
Mailing Address - Country:US
Mailing Address - Phone:971-500-8330
Mailing Address - Fax:
Practice Address - Street 1:909 N BEECH ST UNIT 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1115
Practice Address - Country:US
Practice Address - Phone:971-500-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT2096106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist