Provider Demographics
NPI:1700343670
Name:TAYLOR, STEVE (LCMHCA, LCAS)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LCMHCA, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-9009
Mailing Address - Country:US
Mailing Address - Phone:252-489-3935
Mailing Address - Fax:
Practice Address - Street 1:12 JUNIPER TRL STE 206
Practice Address - Street 2:
Practice Address - City:KITTY HAWK
Practice Address - State:NC
Practice Address - Zip Code:27949-3750
Practice Address - Country:US
Practice Address - Phone:252-573-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22638101YA0400X
NCA14580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)