Healthcare Provider Details

I. General information

NPI: 1962973255
Provider Name (Legal Business Name): LAURIE KATHLEEN TAYLOR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SURREY WAY
WEST HARTFORD CT
06117-1642
US

IV. Provider business mailing address

3 SURREY WAY
WEST HARTFORD CT
06117-1642
US

V. Phone/Fax

Practice location:
  • Phone: 860-222-7151
  • Fax: 866-574-5819
Mailing address:
  • Phone: 860-222-7151
  • Fax: 866-574-5819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: