JEREMIAH TAYLOR (NPI# 1922365691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922365691 |
| Entity Type | Individual |
| Full Name | JEREMIAH TAYLOR |
| Credential | LMFT |
| Practice Address |
812 Oak St Conway AR 72032-4408 |
| Practice Telephone | 5013277100 |
| Practice Fax Number | 5013277121 |
| Mailing Telephone | 5012799000 |
| Mailing Fax Number | 5012799011 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2018-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0261L | AR | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
P1810139 | AR | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | M0708004 | AR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | LICENSED ALCOHOLISM AND DRUG ABUSE COUNSELOR | 0261L | 01 |
| AR | LMFT | M0708004 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 120 Meghan Ln, Judsonia, AR 720819302 | 5017294479 | 5017293537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780698449 | Jeremiah Taylor | Counselor | 3086 Woodley Road, Suite 3, Montgomery, AL 36116-5404 | 2006-07-28 |
| 1386198562 | Jeremiah E Taylor | Dentist | 808 Ne Mall Blvd, Hurst, TX 76053-4653 | 2016-08-05 |
| 1366897183 | Jeremiah Taylor | Student in an Organized Health Care Education/Training Program | 1005 Dr Db Todd Jr Blvd, Meharry Medical College, Nashville, TN 37208-3501 | 2016-04-29 |
| 1932331733 | Jeremiah Ezekiel Taylor | Pharmacist | 525 N State of Franklin Rd, Johnson City, TN 37604-8213 | 2009-08-13 |
| Street Address |
812 OAK ST |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-4408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124636915 | Kimberly Le | Nurse Practitioner | 812 Oak St, Conway, AR 72032-4408 | 2020-07-17 |
| 1043845431 | Lakyn Michelle Phillips | Physician Assistant | 812 Oak St, Conway, AR 72032-4408 | 2020-03-06 |
| 1336605914 | Maria Renae Anderson | Physician Assistant | 812 Oak St, Conway, AR 72032-4408 | 2019-02-19 |
| 1639641947 | Molly M Lensing | Physician Assistant | 812 Oak St, Conway, AR 72032-4408 | 2018-12-27 |
| 1093255325 | Lauren Schultz | Physician Assistant | 812 Oak St, Conway, AR 72032 | 2017-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598257701 | Casondra R Robinson | Counselor | 1720 Simms St, Conway, AR 72034-6416 | 2018-06-04 |
| 1316461510 | Renew Counseling | Counselor | 1237 Front St, Conway, AR 72032-4101 | 2017-07-29 |
| 1720515638 | Poindexter Counseling LLC | Counselor | 800 Legion St Ste 200b, Conway, SC 29526-4825 | 2017-05-23 |
| 1528489192 | Scott K Grainger | Counselor | 105 Hampton Ridge Rd, Conway, SC 29527-3975 | 2013-12-26 |
| 1194158394 | Alan J Hahn | Counselor | 1308 Oak St Unit A, Conway, AR 72034-5339 | 2013-08-12 |
| 1245570845 | Lynn Smith Hucks | Counselor | 6720 Elbow Rd, Conway, SC 29527-6471 | 2013-02-20 |
| 1831494905 | Tresvil Gerard Pack | Counselor | 930 Wingate St Ste D2, Conway, AR 72034-4837 | 2011-01-20 |
| 1124239538 | Wendy J Blackwood | Counselor | 1422 Caldwell St, Conway, AR 72034-5319 | 2007-05-25 |
| 1770608598 | Lydia Willingham | Counselor | 1119 3rd Ave, Conway, SC 29526-5135 | 2007-03-20 |
| 1942300975 | Phyllis Jordan Stalvey | Counselor | 400 Laurel St, Conway, SC 29526-4317 | 2006-09-22 |
| Find all providers in CONWAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.