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NPI Code Detail

MEDICARE: TAYLOR MARTIN M.S., LPC

MEDICARE: TAYLOR MARTIN M.S., LPC
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
1101YM0800XMental Health Counselor7763LA

General Provider Information

NPI Number : 1639642168
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MARTIN M.S., LPC
Provider Business Mailing Address
First Line : PO BOX 289
Second Line :
City : YOUNGSVILLE
State : LA
Zip : 70592-0289
Country : US
Telephone Number : 337-349-1290
Fax Number :
Provider Business Practice Location Address
First Line : 5475 ESSEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3737
Country : US
Telephone Number : 337-349-1290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2019
Last Update Date : 09/28/2023

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