MEDICARE: CHARESE TAYLOR LMFT

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0818	KY
2	1041C0700X	Clinical Social Worker	6956	KY
3	106H00000X	Marriage & Family Therapist	MFT001835	GA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1235469719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARESE TAYLOR LMFT

Provider Business Mailing Address
First Line	:	88 LINDSEY LN STE C
Second Line	:
City	:	SAINT MARYS
State	:	GA
Zip	:	31558-1725
Country	:	US
Telephone Number	:	912-552-7435
Fax Number	:	912-341-6794

Provider Business Practice Location Address
First Line	:	88 LINDSEY LN STE C
Second Line	:
City	:	SAINT MARYS
State	:	GA
Zip	:	31558-1725
Country	:	US
Telephone Number	:	912-552-7435
Fax Number	:	912-341-6794

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

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	01/23/2026

88 LINDSEY LN STE D
SAINT MARYS, GA
31558-1725

Practice Phone: 912-439-2009
Practice Fax: