Provider Demographics
NPI:1811682719
Name:GILMORE, TAYLOR (LPC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:GILMORE
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 1:3430 WILDEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1445
Mailing Address - Country:US
Mailing Address - Phone:850-691-8802
Mailing Address - Fax:
Practice Address - Street 1:2017 CANYON RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1900
Practice Address - Country:US
Practice Address - Phone:205-206-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC04887101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health