MEDICARE: TAYLOR WELLNESS COUNSELING SERVICES

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1447991369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLOR WELLNESS COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	22203 NORTHLAND DR STE 2
Second Line	:
City	:	PARIS
State	:	MI
Zip	:	49338-9487
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22203 NORTHLAND DR STE 2
Second Line	:
City	:	PARIS
State	:	MI
Zip	:	49338-9487
Country	:	US
Telephone Number	:	231-679-1301
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JERILYN TAYLOR
Credential	:
Telephone Number	:	231-679-1301

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	04/05/2022

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