Provider Demographics
NPI:1922215441
Name:TAYLOR, STEVEN EDWIN (MA, LIMHP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:EDWIN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MA, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13435 A ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3658
Mailing Address - Country:US
Mailing Address - Phone:402-697-3923
Mailing Address - Fax:402-697-3924
Practice Address - Street 1:4732 S 131ST ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1822
Practice Address - Country:US
Practice Address - Phone:402-697-3923
Practice Address - Fax:402-697-3924
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE388101YM0800X
NE471101YM0800X
NE737101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47082303526Medicaid