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NPI Code Detail

MEDICARE: TAYLOR ALEXANDRA WILSON LPC

MEDICARE: TAYLOR ALEXANDRA WILSON LPC
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
1101YP2500XProfessional CounselorP2504008AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518601913
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR ALEXANDRA WILSON LPC
Provider Business Mailing Address
First Line : 1310 W MAIN ST STE 201
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-2803
Country : US
Telephone Number : 479-968-2001
Fax Number :
Provider Business Practice Location Address
First Line : 814 HIGDON FERRY RD
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6128
Country : US
Telephone Number : 501-397-1495
Fax Number : 501-397-1495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2022
Last Update Date : 02/16/2026

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Directions to “ TAYLOR ALEXANDRA WILSON LPC” Practice Location

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