Active NPI
Jessica Lynn Taylor, CPRC-A
- Counselor
- Indianapolis, IN
National Provider Identifier
1003762915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CAPRC1-6343
- Practice address
- 4010 W 86TH St Ste D
Indianapolis, IN 46268-1779 - Phone
- (317) 647-0102
- NPI assigned
- Mar 5, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CAPRC1-6343 | IN | Primary |
Addresses
Primary practice location
4010 W 86TH St Ste D
Indianapolis, IN 46268-1779
Mailing address
4010 W 86TH St Ste D
Indianapolis, IN 46268-1779
Phone (317) 647-0102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAPRC1-6343 | IN | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valle Vista LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Methadone Clinic
- Indianapolis, IN
- NPI 1548036262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772668800000",
"number": "1003762915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 W 86TH ST STE D",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462681779",
"telephone_number": "317-647-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 W 86TH ST STE D",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462681779",
"telephone_number": "317-647-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "CPRC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-03-05",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IN",
"license": "CAPRC1-6343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.