Healthcare Provider Details

I. General information

NPI: 1922579424
Provider Name (Legal Business Name): TAYLOR BRIANNA VINSON LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS TAYLOR CUMMINS

II. Dates (important events)

Enumeration Date: 12/09/2018
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 GATEWAY BLVD
MOORESVILLE NC
28117-5540
US

IV. Provider business mailing address

135 PLANTERS DR
STATESVILLE NC
28677-9789
US

V. Phone/Fax

Practice location:
  • Phone: 704-303-1303
  • Fax: 704-831-5308
Mailing address:
  • Phone: 704-345-8412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14247
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28511
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number14247
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: