MEDICARE: TARA LANE-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	11932	NC
2	101YP2500X	Professional Counselor	11932	NC
3	101Y00000X	Counselor	11932	NC

General Provider Information

NPI Number	:	1851444764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA LANE-TAYLOR

Provider Business Mailing Address
First Line	:	129 NATIONAL DR
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371-5602
Country	:	US
Telephone Number	:	910-635-6285
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 NATIONAL DR
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371-5602
Country	:	US
Telephone Number	:	910-635-6285
Fax Number	:

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	06/26/2025

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Directions to “ TARA LANE-TAYLOR ” Practice Location

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