Healthcare Provider Details

I. General information

NPI: 1649997461
Provider Name (Legal Business Name): TAYLOR CURTI LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR PEARSON LGSW

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 37TH AVE S
MOORHEAD MN
56560-5524
US

IV. Provider business mailing address

2701 12TH AVE S
FARGO ND
58103-8753
US

V. Phone/Fax

Practice location:
  • Phone: 701-451-4811
  • Fax: 651-925-0057
Mailing address:
  • Phone: 701-451-4900
  • Fax: 651-925-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number31604
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: