Healthcare Provider Details

I. General information

NPI: 1669103131
Provider Name (Legal Business Name): TAYLOR MCDOWELL M.ED, LAPC, CADC-II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 08/29/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BRODICK LN
LITHIA SPRINGS GA
30122-6887
US

IV. Provider business mailing address

260 PEACHTREE ST. NE SUITE 2200
ATLANTA GA
30303
US

V. Phone/Fax

Practice location:
  • Phone: 229-630-8591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAPC008521
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: