Provider Demographics
NPI:1669221834
Name:TAYLORED COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:TAYLORED COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TORA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR-GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-360-0032
Mailing Address - Street 1:PO BOX 385
Mailing Address - Street 2:
Mailing Address - City:SAXAPAHAW
Mailing Address - State:NC
Mailing Address - Zip Code:27340-0385
Mailing Address - Country:US
Mailing Address - Phone:919-360-0032
Mailing Address - Fax:866-473-0253
Practice Address - Street 1:947 JILL DR
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-9849
Practice Address - Country:US
Practice Address - Phone:919-360-0032
Practice Address - Fax:866-473-0253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-18
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty