| Kc Taylor Llc | |
|
703 Mill Creek Rd Ste E3 Manahawkin NJ 08050-3804 | |
| (619) 549-9279 | |
| Not Available |
| Full Name | Kc Taylor Llc |
|---|---|
| Speciality | Psychologist |
| Location | 703 Mill Creek Rd Ste E3, Manahawkin, New Jersey |
| Authorized Official Name and Position | Kelly C Taylor (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6195499279 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kc Taylor Llc 703 Mill Creek Rd Ste E3 Manahawkin NJ 08050-3804 Ph: (619) 549-9279 | Kc Taylor Llc 703 Mill Creek Rd Ste E3 Manahawkin NJ 08050-3804 Ph: (619) 549-9279 |
| NPI Number | 1972261394 |
|---|---|
| Provider Enumeration Date | 12/02/2021 |
| Last Update Date | 12/02/2021 |
| Certification Date | 12/02/2021 |
| Medicare PECOS PAC ID | 4587058896 |
|---|---|
| Medicare Enrollment ID | O20220303000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972261394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly C Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275946576 PECOS PAC ID: 5496149700 Enrollment ID: I20220303000191 |
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