Provider Demographics
NPI:1902403231
Name:TAYLOR M. THARP, LLC
Entity Type:Organization
Organization Name:TAYLOR M. THARP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:THARP
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S, LICDC
Authorized Official - Phone:614-738-8646
Mailing Address - Street 1:10359 HINTON MILL RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8657
Mailing Address - Country:US
Mailing Address - Phone:614-738-8646
Mailing Address - Fax:
Practice Address - Street 1:2710 BILLINGSLEY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5978
Practice Address - Country:US
Practice Address - Phone:614-738-8646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health