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General NPI Number Information
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NPI Number | 1295229391
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Entity Type | Individual
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Provider Name | NICOLE MAUPIN TAYLOR LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 137 LAXTON RD STE 200
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City | LYNCHBURG
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State | VA
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Zip | 24502-5294
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Country | US
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Telephone | 434-604-0134
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Fax | 434-300-5558
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Provider Business Mailing Address
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Address Line | 137 LAXTON RD STE 200
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City | LYNCHBURG
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State | VA
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Zip | 24502-5294
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Country | US
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Telephone | 434-604-0134
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Fax | 434-300-5558
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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 | 0701007716
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License Number State | VA
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