Provider Demographics
NPI:1760057525
Name:O'HERN, TAYLOR (LMHCA)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:O'HERN
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17039 PUNTLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46062-6520
Mailing Address - Country:US
Mailing Address - Phone:317-989-6089
Mailing Address - Fax:
Practice Address - Street 1:6544 FERGUSON ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1178
Practice Address - Country:US
Practice Address - Phone:317-676-9551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001328A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health