Provider Demographics
NPI:1891069910
Name:LD TAYLOR & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:LD TAYLOR & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LATRICIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:918-392-7875
Mailing Address - Street 1:2448 E 81ST ST
Mailing Address - Street 2:SUITE 4824
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4250
Mailing Address - Country:US
Mailing Address - Phone:918-392-7875
Mailing Address - Fax:800-260-7966
Practice Address - Street 1:2448 E 81ST ST
Practice Address - Street 2:SUITE 4824
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4250
Practice Address - Country:US
Practice Address - Phone:918-392-7875
Practice Address - Fax:800-260-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3886101YP2500X
OK3911101YP2500X
OK3918101YP2500X
OK889106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty