Healthcare Provider Details

I. General information

NPI: 1356264352
Provider Name (Legal Business Name): TAYLOR DICKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 PARKLANE RD
SWARTHMORE PA
19081-2331
US

IV. Provider business mailing address

141 W ALBEMARLE AVE
LANSDOWNE PA
19050-1104
US

V. Phone/Fax

Practice location:
  • Phone: 267-357-2707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: