Individual
MS. JERILYN TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
615 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 542-0352
(208) 542-0359
Mailing address
615 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 542-0352
(208) 542-0359
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
03 197
ID
101YM0800X
Mental Health Counselor
LPC-6094
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841668761
NPI
ID
Enumeration date
09/09/2015
Last updated
04/08/2019
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