Provider Demographics
NPI:1689404642
Name:TAYLOR, LATASHA KIANA (MA, LMHP-R)
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:KIANA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, LMHP-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 HAMMERHEAD CIR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6305
Mailing Address - Country:US
Mailing Address - Phone:757-332-8441
Mailing Address - Fax:
Practice Address - Street 1:4520 HOLLAND OFFICE PARK STE 418
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1145
Practice Address - Country:US
Practice Address - Phone:757-332-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health