MEDICARE: DR. LATRICIA TAYLOR

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	LPC010877	GA

General Provider Information

NPI Number	:	1104641851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LATRICIA TAYLOR

Provider Business Mailing Address
First Line	:	186 WAVERTREE DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-8513
Country	:	US
Telephone Number	:	478-808-7873
Fax Number	:

Provider Business Practice Location Address
First Line	:	186 WAVERTREE DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-8513
Country	:	US
Telephone Number	:	478-808-7873
Fax Number	:

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

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	02/14/2026

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