Provider Demographics
NPI:1710012042
Name:TAYLOR, JANIE JONES (MS)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:JONES
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 LANDMARK ST STE 7A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7688
Mailing Address - Country:US
Mailing Address - Phone:252-355-2801
Mailing Address - Fax:252-355-4708
Practice Address - Street 1:3219 LANDMARK ST STE 7A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7688
Practice Address - Country:US
Practice Address - Phone:252-355-2801
Practice Address - Fax:252-355-4708
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC722106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC195927OtherMEDCOST
NC6105163Medicaid
NC1440NOtherBCBS