Provider Demographics
NPI:1356107940
Name:CHUMLEY, TAYLOR ALEXIS
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXIS
Last Name:CHUMLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22823 NORTHAMPTON PINES DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-5004
Mailing Address - Country:US
Mailing Address - Phone:832-499-2193
Mailing Address - Fax:
Practice Address - Street 1:22823 NORTHAMPTON PINES DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-5004
Practice Address - Country:US
Practice Address - Phone:832-499-2193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X
TX97635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator