Healthcare Provider Details

I. General information

NPI: 1881502656
Provider Name (Legal Business Name): MICAH LERON TAYLOR LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27801 EUCLID AVE STE 520
EUCLID OH
44132-3500
US

IV. Provider business mailing address

1641 WOODHURST AVE
MAYFIELD HEIGHTS OH
44124-3407
US

V. Phone/Fax

Practice location:
  • Phone: 216-350-6836
  • Fax: 216-505-5559
Mailing address:
  • Phone: 412-298-7404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2613643
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: