Provider Demographics
NPI:1841527298
Name:TAYLOR, NICOLE E (PHD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 FORD LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-1864
Mailing Address - Country:US
Mailing Address - Phone:303-803-3069
Mailing Address - Fax:
Practice Address - Street 1:2955 100TH ST STE 3
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-5526
Practice Address - Country:US
Practice Address - Phone:515-612-7004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3533103TC1900X
IA1098103TC1900X
IA001098103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling