MEDICARE: KAYE REYNOLDS TAYLOR

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1205275096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYE REYNOLDS TAYLOR

Provider Business Mailing Address
First Line	:	1525 SPRING PLACE RD SE
Second Line	:	APT 523
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3299
Country	:	US
Telephone Number	:	423-718-8309
Fax Number	:

Provider Business Practice Location Address
First Line	:	183 1ST ST NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-5003
Country	:	US
Telephone Number	:	423-718-8309
Fax Number	:

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

Provider Enumeration Date	:	06/14/2013
Last Update Date	:	06/14/2013

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