Active NPI
Takara Taylor, LLP
- Psychologist
- Caledonia, MI
National Provider Identifier
1356883003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361008044
- Practice address
- 6505 Cherry Meadow Dr SE
Caledonia, MI 49316-9484 - Phone
- (616) 891-8770
- NPI assigned
- Nov 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6362009539 | MI | |
| Behavior Technician | 106S00000X | MI | ||
| Psychologist | 103T00000X | 6361008044 | MI | Primary |
Addresses
Primary practice location
6505 Cherry Meadow Dr SE
Caledonia, MI 49316-9484
Mailing address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000
Other practice location 1
300 68th St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000
Other practice location 2
3300 36th St SE
Grand Rapids, MI 49512-2810
Phone (616) 589-2053
Other practice location 3
1260 Ekhart St NE
Grand Rapids, MI 49503
Phone (616) 589-2053
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356883003 | Medicaid | MI | |
| $$$$$$$$$ | Other | MI | TECHNICIAN |
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 |
|---|---|---|---|
| 6361008044 | MI | MD | Psychologist |
| 6362009539 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1356883003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-455-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6505 CHERRY MEADOW DR SE",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "493169484",
"telephone_number": "616-891-8770"
}
],
"practiceLocations": [
{
"address_1": "300 68th St SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495486927",
"country_code": "US",
"telephone_number": "616-455-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3300 36th St SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495122810",
"country_code": "US",
"telephone_number": "616-589-2053",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1260 Ekhart St NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "49503",
"country_code": "US",
"telephone_number": "616-589-2053",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAYLOR",
"first_name": "TAKARA",
"name_prefix": "Mrs.",
"credential": "LLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-11",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6362009539",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361008044",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1356883003",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TECHNICIAN",
"identifier": "$$$$$$$$$",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Caledonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.