Provider Demographics
NPI:1811540404
Name:TAYLOR, STEPHANIE MICHELLE (LPC)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 WESTMINSTER AVE # 1052
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-1387
Mailing Address - Country:US
Mailing Address - Phone:832-808-9812
Mailing Address - Fax:713-583-9565
Practice Address - Street 1:20719 GRAYDEN DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7677
Practice Address - Country:US
Practice Address - Phone:832-808-9812
Practice Address - Fax:713-583-9565
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61292578101Y00000X, 101YM0800X, 101YP2500X
TX73086101Y00000X, 101YP2500X, 101YM0800X
COLPC0015884101Y00000X, 101YM0800X, 101YP2500X
WI22302875101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4023822Medicaid
TX4023822Medicaid