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General NPI Number Information
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NPI Number | 1003709908
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Entity Type | Organization
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Legal Business Name | TAYLOR HEALING INSTITUTE
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1514 CRESTMARK BLVD APT 1514
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-4431
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Country | US
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Telephone | 312-379-9790
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Fax | 312-379-9790
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Provider Business Mailing Address
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Address Line | 1440 W TAYLOR ST # 482
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City | CHICAGO
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State | IL
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Zip | 60607-4623
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Country | US
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Telephone | 312-379-9790
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Fax | 312-379-9790
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Authorized Official
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Title or Position | LICENSED CLINICAL PROFESSIONAL COUN
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Name | MS. STEPHANIE TAYLOR
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Credential | LCPC
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Telephone | 312-379-9790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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