Provider Demographics
NPI:1932116084
Name:TAYLOR, BENNY FRANK (LPC)
Entity Type:Individual
Prefix:
First Name:BENNY
Middle Name:FRANK
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 ARROYO PINON DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5039
Mailing Address - Country:US
Mailing Address - Phone:928-634-2236
Mailing Address - Fax:928-634-8960
Practice Address - Street 1:8 E COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4382
Practice Address - Country:US
Practice Address - Phone:928-634-2236
Practice Address - Fax:928-634-8960
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-12369101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional