Shirley Evon Taybron, MED. NBCC LCMHC-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

S2018 Issued in NC

Practice address

5135 Morganton Rd Ste 102
Fayetteville, NC 28314-1525

Phone

(910) 864-0390

Fax

(910) 401-1722

NPI assigned

Jun 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1891991030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58531",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283058531",
            "telephone_number": "910-864-0390",
            "fax_number": "910-864-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 MORGANTON RD STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141525",
            "telephone_number": "910-864-0390",
            "fax_number": "910-401-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYBRON",
        "first_name": "SHIRLEY",
        "middle_name": "EVON",
        "name_prefix": "Mrs.",
        "credential": "MED.  NBCC  LCMHC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S2018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103617",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea West Tatman, CCC-SLP
• Angela Tatum Malloy
• Za'Vette Mignon Tatum-Kodzai, MD
• Tihara Aynaara Taverner, LCSWA
• Chioma Ohiri Tawose, FNP-BC
• Emi Denise Taylor Hewitt, CAA
• Andrea Taylor, PA
• Angeleta Taylor, MD
• Angie M Taylor, MS, LAT, ATC
• Bridget Roxanne Taylor, LPC

• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.