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General NPI Number Information
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NPI Number | 1114916574
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Entity Type | Individual
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Provider Name | LISA A TAYLOR-AUSTIN NCC, LPC, LMHC, CFMH
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Gender | Female
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 57 PLAINS RD SUITE 2C
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City | MILFORD
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State | CT
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Zip | 06461-2573
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Country | US
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Telephone | 203-522-6164
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Fax | 855-855-1870
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Provider Business Mailing Address
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Address Line | 415 BOSTON POST RD STE 3-1118
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City | MILFORD
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State | CT
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Zip | 06460-2578
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Country | US
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Telephone | 203-522-6164
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Fax | 855-855-1870
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0019290
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1282
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License Number State | CT
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