Provider Demographics
NPI:1053806893
Name:TAYLOR, ANGELA LYNETTE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNETTE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 PILOT HOUSE DR STE 200B780
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1993
Mailing Address - Country:US
Mailing Address - Phone:757-586-5542
Mailing Address - Fax:757-240-4380
Practice Address - Street 1:780 PILOT HOUSE DR STE 200B780
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1993
Practice Address - Country:US
Practice Address - Phone:757-609-1076
Practice Address - Fax:757-609-1076
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health