Healthcare Provider Details

I. General information

NPI: 1972975720
Provider Name (Legal Business Name): TAYLOR MACHINIAK LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MARTIN LUTHER KING BLVD
FLINT MI
48502-2002
US

IV. Provider business mailing address

1530 LONE OAK RD
PADUCAH KY
42003-7901
US

V. Phone/Fax

Practice location:
  • Phone: 810-232-5641
  • Fax:
Mailing address:
  • Phone: 513-853-8520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW00001730
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.2608418
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: