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General NPI Number Information
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NPI Number | 1760021737
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Entity Type | Individual
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Provider Name | TAYLOR JOHNSON MRC, LPCC
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Gender | Male
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Dates
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Enumeration Date | 12/23/2019
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 820 DOLWICK DR
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City | ERLANGER
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State | KY
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Zip | 41018-2774
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Country | US
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Telephone | 859-287-3370
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Fax |
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Provider Business Mailing Address
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Address Line | 4407 CLOVERHILL TER
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City | CINCINNATI
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State | OH
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Zip | 45238-6107
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Country | US
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Telephone | 502-445-3565
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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 | 261064
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License Number State | KY
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