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NPI Code Detail

MEDICARE: TAYLOR NICOLETTE MELTON

MEDICARE: TAYLOR NICOLETTE MELTON
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1437819422
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR NICOLETTE MELTON
Provider Business Mailing Address
First Line : 2707 N HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1413
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2707 N HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1413
Country : US
Telephone Number : 708-364-0580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2021
Last Update Date : 12/18/2021

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Directions to “ TAYLOR NICOLETTE MELTON ” Practice Location

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