Provider Demographics
NPI:1619796828
Name:TAYLORED PATH PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:TAYLORED PATH PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HAUN
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:913-286-8500
Mailing Address - Street 1:11569 S SKYVIEW LN
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-6544
Mailing Address - Country:US
Mailing Address - Phone:913-286-8500
Mailing Address - Fax:
Practice Address - Street 1:9393 W 110TH ST STE 500
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1464
Practice Address - Country:US
Practice Address - Phone:913-303-8529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health