Healthcare Provider Details

I. General information

NPI: 1174294177
Provider Name (Legal Business Name): TAYLOR MADISON TAYLOR LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 W MAIN ST
WEST UNION OH
45693-1303
US

IV. Provider business mailing address

383 BACK RD
IRONTON OH
45638-8071
US

V. Phone/Fax

Practice location:
  • Phone: 740-302-7551
  • Fax:
Mailing address:
  • Phone: 740-302-7551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614409
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: