Provider Demographics
NPI:1891786463
Name:MAYER, TAYLOR A (LCPC, PHD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:A
Last Name:MAYER
Suffix:
Gender:M
Credentials:LCPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5542 WALTER HAGEN DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1005
Mailing Address - Country:US
Mailing Address - Phone:406-690-5086
Mailing Address - Fax:
Practice Address - Street 1:1629 AVENUE D STE 2
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3054
Practice Address - Country:US
Practice Address - Phone:406-690-5086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional