Healthcare Provider Details

I. General information

NPI: 1982541009
Provider Name (Legal Business Name): BRAXTON JOSHUA TAYLOR MSW, LCSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N WINSTEAD AVE STE 260
ROCKY MOUNT NC
27804-8757
US

IV. Provider business mailing address

901 N WINSTEAD AVE STE 260
ROCKY MOUNT NC
27804-8757
US

V. Phone/Fax

Practice location:
  • Phone: 252-210-6530
  • Fax: 252-210-6531
Mailing address:
  • Phone: 252-210-6530
  • Fax: 252-210-6531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023586
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: