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NPI Code Detail

MEDICARE: ALEXANDRA GRACE TAYLOR

MEDICARE: ALEXANDRA GRACE 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
1101YM0800XMental Health Counselor
2101YM0800XMental Health CounselorR7127OR
3101YM0800XMental Health CounselorC9573OR

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 : 1821633769
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA GRACE TAYLOR
Provider Business Mailing Address
First Line : 3949 SOUTH 6TH STREET
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97603
Country : US
Telephone Number : 541-882-1487
Fax Number : 541-880-5590
Provider Business Practice Location Address
First Line : 6000 NEW WAY
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-9382
Country : US
Telephone Number : 541-884-1841
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2019
Last Update Date : 06/27/2025

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Directions to “ ALEXANDRA GRACE TAYLOR ” Practice Location

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