Provider Demographics
NPI:1609458538
Name:TAYLOR, KEVIN (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 BRIDLE PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3607
Mailing Address - Country:US
Mailing Address - Phone:719-310-5933
Mailing Address - Fax:
Practice Address - Street 1:1785 N ACADEMY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2733
Practice Address - Country:US
Practice Address - Phone:719-357-6637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor