Provider Demographics
NPI:1063988624
Name:TAYLOR, MELISSA M (LPC/MHSP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 BUD WARD LN
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37642-6258
Mailing Address - Country:US
Mailing Address - Phone:802-487-7191
Mailing Address - Fax:
Practice Address - Street 1:146 BUD WARD LN
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:TN
Practice Address - Zip Code:37642-6258
Practice Address - Country:US
Practice Address - Phone:802-487-7191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0133651101YM0800X
TN6890101YM0800X
VT151.0133648101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)