MEDICARE: KENDRA CAROLINE 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

General Provider Information

NPI Number	:	1396465928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA CAROLINE TAYLOR

Provider Business Mailing Address
First Line	:	PO BOX 12473
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97309-0473
Country	:	US
Telephone Number	:	503-343-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 FRONT ST NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-0775
Country	:	US
Telephone Number	:	503-420-3194
Fax Number	:

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

Provider Enumeration Date	:	09/01/2022
Last Update Date	:	02/02/2026

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Directions to “ KENDRA CAROLINE TAYLOR ” Practice Location

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