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NPI Code Detail

MEDICARE: TAYLOR SITORIUS LPC

MEDICARE: TAYLOR SITORIUS 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 Counselor11513WI

General Provider Information

NPI Number : 1770379786
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR SITORIUS LPC
Provider Business Mailing Address
First Line : 34700 VALLEY RD
Second Line :
City : OCONOMOWOC
State : WI
Zip : 53066-4500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2424 S 102ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-2106
Country : US
Telephone Number : 800-767-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2025
Last Update Date : 04/16/2025

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Directions to “ TAYLOR SITORIUS LPC” Practice Location

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