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General NPI Number Information
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NPI Number | 1962389072
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Entity Type | Individual
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Provider Name | TAYLOR VAUGHN MARTIN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 24100 CHAGRIN BLVD STE 125
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City | BEACHWOOD
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State | OH
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Zip | 44122-5535
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Country | US
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Telephone | 833-254-3278
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Fax |
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Provider Business Mailing Address
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Address Line | 27663 CAROLINE CIR
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City | WESTLAKE
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State | OH
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Zip | 44145-1164
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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 | C.2507034-TRNE
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License Number State | OH
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