MEDICARE: COURTNEY TAYLOR BCBA, LBA

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	103K00000X	Behavior Analyst	L-423	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L-423	OTHER	LA	STATE LICENSE TO PRACTICE APPLIED BEHAVIOR ANALYSIS
2	1-19-40105	OTHER		BEHAVIOR ANALYST CERTIFICATION BOARD

General Provider Information

NPI Number	:	1760012470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY TAYLOR BCBA, LBA

Provider Business Mailing Address
First Line	:	PO BOX 1823
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71294-1823
Country	:	US
Telephone Number	:	318-588-8908
Fax Number	:	318-588-8909

Provider Business Practice Location Address
First Line	:	2808 KILPATRICK BLVD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5139
Country	:	US
Telephone Number	:	318-588-8909
Fax Number	:	318-588-8909

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

Provider Enumeration Date	:	01/22/2020
Last Update Date	:	12/01/2025

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