Healthcare Provider Details

I. General information

NPI: 1528986502
Provider Name (Legal Business Name): JOSHUA R TAYLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HARTWELL AVE
LEXINGTON MA
02421-3100
US

IV. Provider business mailing address

44 REYNARD ST NULL
GLOUCESTER MA
01930-1821
US

V. Phone/Fax

Practice location:
  • Phone: 978-762-3936
  • Fax:
Mailing address:
  • Phone: 351-444-8665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: