Provider Demographics
NPI:1144688235
Name:TAYLOR, DAVID RAY (LPC, LMSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RAY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LPC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8299 SILVER CT
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-8623
Mailing Address - Country:US
Mailing Address - Phone:734-735-2080
Mailing Address - Fax:
Practice Address - Street 1:8299 SILVER CT
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-8623
Practice Address - Country:US
Practice Address - Phone:734-735-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401003958101YP1600X
MI68010188211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical