Healthcare Provider Details

I. General information

NPI: 1598363517
Provider Name (Legal Business Name): CAMERON TAYLOR COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 10/12/2020
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 COLUMBIA ST APT 211
VANCOUVER WA
98660-3469
US

IV. Provider business mailing address

701 COLUMBIA ST APT 211
VANCOUVER WA
98660-3469
US

V. Phone/Fax

Practice location:
  • Phone: 360-450-2336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAMERON TAYLOR
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: LMHC, LPC
Phone: 360-450-2336