Provider Demographics
NPI:1578308128
Name:TAYLOR, SEAN MICHAEL (LMFT)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:TAYLOR
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5019
Mailing Address - Country:US
Mailing Address - Phone:423-464-9052
Mailing Address - Fax:
Practice Address - Street 1:238 BATTLEFIELD BLVD S STE 200
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5233
Practice Address - Country:US
Practice Address - Phone:757-330-2439
Practice Address - Fax:757-974-0041
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1757106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist