Leticia Ann Holub Taylor, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

1284 Issued in KS

Practice address

515 N Mur Len Rd
Olathe, KS 66062-1267

Phone

(913) 375-6273

NPI assigned

Aug 17, 2007

Last updated

Aug 17, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Dr. Tish Taylor Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Aug 30, 2016 through Aug 30, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tish Holub Taylor, PH.D.

  • Psychologist
  • Olathe, KS
  • NPI 1639363716
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1225220858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12125 HORTON ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092771",
            "telephone_number": "913-375-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N MUR LEN RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621267",
            "telephone_number": "913-375-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LETICIA",
        "middle_name": "ANN HOLUB",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KS",
            "license": "1284",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "KS",
            "license": "1284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TISH",
            "last_name": "TAYLOR",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kathryn Tanner
• Tarabi Helping Hand.Inc
• Sladjana Tasic, RPH
• Amanda Evans Tauscher, M.D.
• Kathryn Taylor, RPH, PHARM.D.
• Thomas R Taylor, D.C.
• Rebecca Teaford-Boldridge, LMAC
• Jennifer L Tennis, P.T.A.
• Jenna Tenold, PA-C
• Kelsey Jade Tenpenny, MD

• Clinical Child & Adolescent Psychologist in Olathe, KS
• Providers in Olathe, KS by specialty
• Clinical Child & Adolescent Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.