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General NPI Number Information
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NPI Number | 1255977666
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Entity Type | Individual
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Provider Name | TAYLOR CAITLYN NYBERG LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/20/2019
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 32 MT PLEASANT DR
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City | POUGHQUAG
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State | NY
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Zip | 12570-5900
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Country | US
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Telephone | 845-279-2378
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Fax |
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Provider Business Mailing Address
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Address Line | 32 MT PLEASANT DR
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City | POUGHQUAG
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State | NY
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Zip | 12570-5900
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Country | US
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Telephone | 845-392-6638
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 002251
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License Number State | NY
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