Provider Demographics
NPI:1538960109
Name:TAYLOR, REBECCA L (LCDC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:
Credentials:LCDC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:L
Other - Last Name:LUJAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:853 KINSMAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77328-2512
Mailing Address - Country:US
Mailing Address - Phone:281-786-0001
Mailing Address - Fax:
Practice Address - Street 1:853 KINSMAN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77328-2512
Practice Address - Country:US
Practice Address - Phone:281-786-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)