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General NPI Number Information
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NPI Number | 1275195109
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Entity Type | Individual
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Provider Name | ALEXANDRIA SIMONE TAYLOR LSW
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Gender | Female
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 2601 W MARQUETTE RD
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City | CHICAGO
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State | IL
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Zip | 60629-1817
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Country | US
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Telephone | 773-349-8031
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 W MARQUETTE RD
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City | CHICAGO
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State | IL
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Zip | 60629-1817
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Country | US
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Telephone | 773-349-8031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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