MEDICARE: KELSEY TAYLOR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	259481	KY

General Provider Information

NPI Number	:	1194697748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY TAYLOR LCSW

Provider Business Mailing Address
First Line	:	2427 WOODLAND DR
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-8905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3520 NEW HARTFORD RD STE 300
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-4636
Country	:	US
Telephone Number	:	270-231-2670
Fax Number	:	270-297-1437

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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