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NPI Code Detail

MEDICARE: TAYLOR LAYNE THOMAS LMSW

MEDICARE: TAYLOR LAYNE THOMAS LMSW
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
1104100000XSocial Worker13978TN

General Provider Information

NPI Number : 1649953985
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR LAYNE THOMAS LMSW
Provider Business Mailing Address
First Line : 3778 WINDHAVEN DR
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-1119
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 223 DUNBAR CAVE RD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-8830
Country : US
Telephone Number : 731-608-5211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2023
Last Update Date : 08/11/2023

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