Provider Demographics
NPI:1265258081
Name:ALLEN-DICKSON, TAYLOR NICOLE (LPC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NICOLE
Last Name:ALLEN-DICKSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 SAMS WAY
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3133
Mailing Address - Country:US
Mailing Address - Phone:870-267-4774
Mailing Address - Fax:
Practice Address - Street 1:1515 S CAPITAL OF TEXAS HWY STE 300&310
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6579
Practice Address - Country:US
Practice Address - Phone:448-824-8775
Practice Address - Fax:281-648-2200
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2410013101YP2500X
TX97164101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional