MEDICARE: CHARLENE DENISE 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	:	1730934670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLENE DENISE TAYLOR

Provider Business Mailing Address
First Line	:	639 GRANITE ST
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-5366
Country	:	US
Telephone Number	:	617-847-1996
Fax Number	:	781-843-2403

Provider Business Practice Location Address
First Line	:	639 GRANITE ST
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-5366
Country	:	US
Telephone Number	:	617-847-1996
Fax Number	:	781-843-2403

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

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	03/27/2026

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Directions to “ CHARLENE DENISE TAYLOR ” Practice Location

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