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General NPI Number Information
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NPI Number | 1720700289
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Entity Type | Individual
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Provider Name | TIGIST TAYLOR LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 7252 N ROGERS AVE
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City | CHICAGO
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State | IL
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Zip | 60645-2414
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Country | US
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Telephone | 847-306-8344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6613
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City | EVANSTON
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State | IL
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Zip | 60204-6613
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.014291
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License Number State | IL
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