Provider Demographics
NPI:1376144766
Name:TAYLOR, ARLICIA LAGENE (LPC)
Entity type:Individual
Prefix:MS
First Name:ARLICIA
Middle Name:LAGENE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ARLICIA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 ELDRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-3809
Mailing Address - Country:US
Mailing Address - Phone:404-960-3311
Mailing Address - Fax:
Practice Address - Street 1:905 ELDRIDGE RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-3809
Practice Address - Country:US
Practice Address - Phone:404-960-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17760101YP2500X
GALPC014828101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional