Provider Demographics
NPI:1609613181
Name:KTAYLOR THERAPY AND SUPERVISION LLC
Entity type:Organization
Organization Name:KTAYLOR THERAPY AND SUPERVISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-330-3123
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-8237
Mailing Address - Country:US
Mailing Address - Phone:785-330-3123
Mailing Address - Fax:
Practice Address - Street 1:767 ASH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-5521
Practice Address - Country:US
Practice Address - Phone:785-330-3123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)