Provider Demographics
NPI:1871472282
Name:BURLESON, TAYLOR CAROLYN-JEAN (LCMHC-A)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:CAROLYN-JEAN
Last Name:BURLESON
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MOSS SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-7810
Mailing Address - Country:US
Mailing Address - Phone:704-550-1535
Mailing Address - Fax:704-550-1535
Practice Address - Street 1:7200 CREEDMOOR RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1711
Practice Address - Country:US
Practice Address - Phone:919-912-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21950101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health