Provider Demographics
NPI:1053945485
Name:FRONZAGLIO, TAYLOR NICOLE BARTON (LPCC-S)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NICOLE BARTON
Last Name:FRONZAGLIO
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 TULANE AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4227
Mailing Address - Country:US
Mailing Address - Phone:330-506-8161
Mailing Address - Fax:
Practice Address - Street 1:1714 BOARDMAN POLAND RD STE 10
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-1957
Practice Address - Country:US
Practice Address - Phone:330-568-5651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2103076101YM0800X
OHC.1902095-TRNE390200000X
OHE.2303381-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program