MEDICARE: TAYLOR GREGORY CLOUGH 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	104100000X	Social Worker	44SL06892600	NJ

General Provider Information

NPI Number	:	1366216608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR GREGORY CLOUGH LCSW

Provider Business Mailing Address
First Line	:	150 LINCOLN BLVD APT 2203
Second Line	:
City	:	MIDDLESEX
State	:	NJ
Zip	:	08846-1064
Country	:	US
Telephone Number	:	908-635-1863
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 LINCOLN BLVD
Second Line	:
City	:	MIDDLESEX
State	:	NJ
Zip	:	08846-1060
Country	:	US
Telephone Number	:	908-635-1863
Fax Number	:

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

Provider Enumeration Date	:	11/07/2023
Last Update Date	:	03/18/2026

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