Healthcare Provider Details

I. General information

NPI: 1932046810
Provider Name (Legal Business Name): ELLIOT TAYLOR CHE LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 BLAIRS FERRY RD
MARION IA
52302-3157
US

IV. Provider business mailing address

1655 BLAIRS FERRY RD
MARION IA
52302-3157
US

V. Phone/Fax

Practice location:
  • Phone: 319-261-2292
  • Fax: 319-200-2516
Mailing address:
  • Phone: 319-261-2292
  • Fax: 319-200-2516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: