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General NPI Number Information
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NPI Number | 1568195287
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Entity Type | Individual
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Provider Name | LAKEISHA TAYLOR LCSW-C, LICSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/09/2022
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2709 BLUE RIDGE RD STE 190
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City | RALEIGH
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State | NC
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Zip | 27607-6462
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Country | US
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Telephone | 919-877-6458
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Fax |
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Provider Business Mailing Address
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Address Line | 203 E RANSOM ST APT 3B
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-2533
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Country | US
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Telephone | 443-745-9189
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C018457
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 24751
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License Number State | MD
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