Provider Demographics
NPI:1336740034
Name:DES MARAIS, TAYLOR (LPC-I)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:DES MARAIS
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 DOBBINS AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2841
Mailing Address - Country:US
Mailing Address - Phone:864-561-0253
Mailing Address - Fax:
Practice Address - Street 1:312 E 1ST AVE STE D
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3064
Practice Address - Country:US
Practice Address - Phone:864-561-0253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health