Provider Demographics
NPI:1770053282
Name:PERRYMAN, TAYLOR W (MS, LPC, LMHC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:W
Last Name:PERRYMAN
Suffix:
Gender:F
Credentials:MS, LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 KUNEHI ST APT 205
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2069
Mailing Address - Country:US
Mailing Address - Phone:808-354-4425
Mailing Address - Fax:
Practice Address - Street 1:550 KUNEHI ST APT 205
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2069
Practice Address - Country:US
Practice Address - Phone:808-354-4425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2007036101YP2500X
HIMHC-723101YM0800X
ARA1811162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional