Colleen Taylor, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

001322 Issued in GA

Practice address

1805 Herrington Rd Ste B
Lawrenceville, GA 30043-7987

Phone

(770) 299-9295

NPI assigned

Jul 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 27, 2023 through Jan 27, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1609500719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 OLD DOMINION RD",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303504620",
            "telephone_number": "404-316-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD STE B",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437987",
            "telephone_number": "770-299-9295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 Independence Sq Ste A",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303385165",
            "country_code": "US",
            "telephone_number": "770-299-9295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "001322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asif Taufiq, D.D.S, M.B.A
• Carol Yvette Taylor-Ali, RN
• Daviea Antoinette Taylor-Hicks, PA-C
• Adaky Chidundo Taylor, PA-C
• Charmion Lynell Taylor
• Darcey Jerome Taylor, DMD
• Kristina Michelle Taylor, LCSW
• Leslie Inez Taylor, PCT
• Lorna Elica Taylor, LPC
• Precious E Taylor

• Clinical Psychologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.