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General NPI Number Information
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NPI Number | 1588154348
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Entity Type | Individual
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Provider Name | TAYLOR LOUISE BLACKBURN LPCC, MED
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Gender | Female
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 24803 DETROIT RD UNIT E
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City | WESTLAKE
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State | OH
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Zip | 44145-2553
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Country | US
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Telephone | 440-723-2765
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Fax |
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Provider Business Mailing Address
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Address Line | 214 SEDONA DR
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City | SUMMERVILLE
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State | SC
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Zip | 29486-2462
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Country | US
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Telephone | 330-933-6525
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.2404698
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2103606
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License Number State | OH
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