Healthcare Provider Details

I. General information

NPI: 1265154769
Provider Name (Legal Business Name): TAYLOR EVAN MEFFORD LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 E 21ST ST
BROOKLYN NY
11226-7206
US

IV. Provider business mailing address

1016 BROWN ST STE 101
PEEKSKILL NY
10566-3629
US

V. Phone/Fax

Practice location:
  • Phone: 914-809-0498
  • Fax:
Mailing address:
  • Phone: 385-477-8331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number013749
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: