Provider Demographics
NPI:1932748142
Name:KLESHICK, TAYLOR (LPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:KLESHICK
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 1:3816 CLEAR CREEK RD STE 301
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4400
Mailing Address - Country:US
Mailing Address - Phone:281-993-3733
Mailing Address - Fax:
Practice Address - Street 1:3816 S CLEAR CREEK RD STE C301
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4107
Practice Address - Country:US
Practice Address - Phone:254-773-4022
Practice Address - Fax:254-773-0919
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX76440OtherTEXAS BOARD OF LICENSED PROFESSIONAL COUNSELORS