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General NPI Number Information
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NPI Number | 1275876815
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Entity Type | Individual
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Provider Name | JESSICA LYNN TAYLOR MA, LPCC-S
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Gender | Female
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Dates
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Enumeration Date | 04/02/2013
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 8518 MENTOR AVE STE H
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City | MENTOR
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State | OH
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Zip | 44060-5838
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Country | US
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Telephone | 440-589-6500
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Fax | 440-589-6555
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Provider Business Mailing Address
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Address Line | 7217 HAWTHORNE DR
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City | MENTOR
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State | OH
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Zip | 44060-4632
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Country | US
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Telephone | 440-589-6500
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Fax | 440-589-6555
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C1100260
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License Number State | OH
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