MEDICARE: ANTOINETTE TAYLOR LPCC

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	101YP2500X	Professional Counselor	173485	KY

General Provider Information

NPI Number	:	1518302348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINETTE TAYLOR LPCC

Provider Business Mailing Address
First Line	:	PO BOX 950244
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40295-0244
Country	:	US
Telephone Number	:	502-953-4700
Fax Number	:	502-772-8189

Provider Business Practice Location Address
First Line	:	4229 BARDSTOWN RD STE 212
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-3286
Country	:	US
Telephone Number	:	502-437-5375
Fax Number	:	502-437-5375

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

Provider Enumeration Date	:	05/07/2013
Last Update Date	:	01/19/2025

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