Provider Demographics
NPI:1023888484
Name:TAYLORED COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:TAYLORED COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:434-604-0134
Mailing Address - Street 1:137 LAXTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5294
Mailing Address - Country:US
Mailing Address - Phone:434-604-0134
Mailing Address - Fax:434-300-5558
Practice Address - Street 1:137 LAXTON RD STE 200
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5294
Practice Address - Country:US
Practice Address - Phone:434-604-0134
Practice Address - Fax:434-300-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty