Provider Demographics
NPI:1184478901
Name:TAYLOR, LEAH BRIDGES (LMHC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:BRIDGES
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 ALTADENA PARK CIR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4536
Mailing Address - Country:US
Mailing Address - Phone:850-324-4489
Mailing Address - Fax:
Practice Address - Street 1:402 OFFICE PARK DR STE 208
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2417
Practice Address - Country:US
Practice Address - Phone:205-777-1266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18731101YM0800X
ALALC04410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health