Taylor, Jeremiah

Taylor, Jeremiah is an individual health care provider with primary practice located at 812 Oak St , Conway AR 72032-4408. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Taylor, Jeremiah can be contacted via phone (501) 327-7100.

Contact Information

Primary practice address
812 Oak St Conway AR 72032-4408
Phone: (501) 327-7100
Fax: (501) 327-7121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0261L Arkansas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X M0708004 Arkansas
Behavioral Health & Social Service Providers / Professional 101YP2500X P1810139 Arkansas

Profile Details

NPI number 1922365691
LBN Legal business name Taylor, Jeremiah
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2012
Last updated Dec 27th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922365691 NPPES
Arkansas Other 0261L LICENSED ALCOHOLISM AND DRUG ABUSE COUNSELOR
Arkansas Other M0708004 LICENSED ALCOHOLISM AND DRUG ABUSE COUNSELOR

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