MEDICARE: LAURA H. TAYLOR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C001656	NC
2	1041C0700X	Clinical Social Worker	C001656	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164426904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA H. TAYLOR LCSW

Provider Business Mailing Address
First Line	:	PO BOX 40908
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28309-0908
Country	:	US
Telephone Number	:	910-615-6949
Fax Number	:	910-609-3784

Provider Business Practice Location Address
First Line	:	711 EXECUTIVE PL FL 3
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5193
Country	:	US
Telephone Number	:	910-615-3333
Fax Number	:	910-615-9863

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	04/18/2024

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Directions to “ LAURA H. TAYLOR LCSW” Practice Location

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