Healthcare Provider Details

I. General information

NPI: 1639093123
Provider Name (Legal Business Name): ELLE TAYLOR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 FALLS AVE
TWIN FALLS ID
83301-3370
US

IV. Provider business mailing address

3222 E 3700 N
KIMBERLY ID
83341-5346
US

V. Phone/Fax

Practice location:
  • Phone: 208-329-6113
  • Fax:
Mailing address:
  • Phone: 208-320-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4281822
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: