Provider Demographics
NPI:1023732468
Name:BEATTY-FRAZIER, TAYLOR CHRISTIAN (PEER SERVICES)
Entity type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:CHRISTIAN
Last Name:BEATTY-FRAZIER
Suffix:
Gender:M
Credentials:PEER SERVICES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 CRYSTAL DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2012
Mailing Address - Country:US
Mailing Address - Phone:937-977-0070
Mailing Address - Fax:
Practice Address - Street 1:4124 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-3018
Practice Address - Country:US
Practice Address - Phone:937-522-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.178509101YA0400X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)