MEDICARE: MISS ILA JEAN 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		OH

General Provider Information

NPI Number	:	1619826542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ILA JEAN TAYLOR

Provider Business Mailing Address
First Line	:	445 E 109TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-1437
Country	:	US
Telephone Number	:	216-550-2238
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 E 109TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-1437
Country	:	US
Telephone Number	:	216-550-2238
Fax Number	:

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

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

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Directions to “ MISS ILA JEAN TAYLOR ” Practice Location

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