Provider Demographics
NPI:1720712177
Name:TAYLOR, DINAH S (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:DINAH
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 WARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-9176
Mailing Address - Country:US
Mailing Address - Phone:803-543-2266
Mailing Address - Fax:
Practice Address - Street 1:116 WARDEN WAY
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-9176
Practice Address - Country:US
Practice Address - Phone:803-543-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7589101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC85-4263574Medicaid