Healthcare Provider Details

I. General information

NPI: 1306210885
Provider Name (Legal Business Name): ROBIN TAYLOR LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N RAMAGE ST
SALUDA SC
29138-1359
US

IV. Provider business mailing address

204 N RAMAGE ST
SALUDA SC
29138-1359
US

V. Phone/Fax

Practice location:
  • Phone: 864-445-2968
  • Fax: 864-445-9592
Mailing address:
  • Phone: 864-445-2968
  • Fax: 864-445-9592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5301
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: