MEDICARE: EHT-EL TAYLOR LMHC, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1013208719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EHT-EL TAYLOR LMHC, LMFT

Provider Business Mailing Address
First Line	:	1000 PARKVIEW DR
Second Line	:	APT 827
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2979
Country	:	US
Telephone Number	:	305-331-6891
Fax Number	:

Provider Business Practice Location Address
First Line	:	1990 NE 163RD ST
Second Line	:	SUITE 102
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4854
Country	:	US
Telephone Number	:	305-945-9906
Fax Number	:	305-945-9907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2011
Last Update Date	:	04/28/2011

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