Provider Demographics
NPI:1669563201
Name:TAYLOR, SHERRY L (MA, LPC, LMFT, NCC)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, LPC, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 KINGSRIDE LN # 299
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4116
Mailing Address - Country:US
Mailing Address - Phone:713-660-8877
Mailing Address - Fax:713-660-9697
Practice Address - Street 1:2411 FOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 217
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4817
Practice Address - Country:US
Practice Address - Phone:713-660-8877
Practice Address - Fax:713-660-9697
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00145974163WS0200X
TX10125101YP2500X
TX002029106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095578303Medicaid