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General NPI Number Information
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NPI Number | 1174494991
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Entity Type | Individual
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Provider Name | CARLA TAYLOR LSATP
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 4212 PARK PLACE CT.
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City | GLEN ALLEN
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State | VA
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Zip | 23060
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Country | US
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Telephone | 804-315-3135
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Fax | 804-728-1086
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Provider Business Mailing Address
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Address Line | 3709 PEPPERCORN WAY
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City | CHESAPEAKE
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State | VA
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Zip | 23321
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Country | US
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Telephone | 757-641-2446
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0718000620
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License Number State | VA
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