Healthcare Provider Details
I. General information
NPI: 1730493347
Provider Name (Legal Business Name): DENZIE W. TAYLOR LCSW, MCAP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/06/2010
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1265 KASS CIRCLE
SPRING HILL FL
34606-4308
US
IV. Provider business mailing address
3261 COMMERCIAL WAY
SPRING HILL FL
34606-2694
US
V. Phone/Fax
- Phone: 352-686-3188
- Fax: 352-686-9394
- Phone: 352-686-3188
- Fax: 352-686-9394
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | MCAP100113 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 34006025A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | SW11501 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: