Healthcare Provider Details

I. General information

NPI: 1689457731
Provider Name (Legal Business Name): KILEY JEAN TAYLOR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KILEY JEAN STUDER LMSW

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2178 HIGHWAY 62 412
HIGHLAND AR
72542-9478
US

IV. Provider business mailing address

1001 N MISSOURI AVE
CORNING AR
72422-7011
US

V. Phone/Fax

Practice location:
  • Phone: 870-994-2202
  • Fax: 870-994-2328
Mailing address:
  • Phone: 870-857-3334
  • Fax: 870-857-9934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13008-C
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: