Provider Demographics
NPI:1689759243
Name:TAYLOR, TERRY LYNNA (LPC)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:LYNNA
Last Name:TAYLOR
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:PO BOX 451
Mailing Address - Street 2:
Mailing Address - City:ROLLINSVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80474-0451
Mailing Address - Country:US
Mailing Address - Phone:303-601-9222
Mailing Address - Fax:303-258-3563
Practice Address - Street 1:2960 DORY HILL RD
Practice Address - Street 2:
Practice Address - City:BLACK HAWK
Practice Address - State:CO
Practice Address - Zip Code:80422-8771
Practice Address - Country:US
Practice Address - Phone:303-601-9222
Practice Address - Fax:303-258-3563
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health