MEDICARE: LISA MARIE TAYLOR

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	104100000X	Social Worker	LSW.0009925558	CO

General Provider Information

NPI Number	:	1275488322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MARIE TAYLOR

Provider Business Mailing Address
First Line	:	1014 CRAGMORE DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4332
Country	:	US
Telephone Number	:	970-430-6768
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 TWIN WASH SQ
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-9438
Country	:	US
Telephone Number	:	970-430-6768
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ LISA MARIE TAYLOR ” Practice Location

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