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General NPI Number Information
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NPI Number | 1831883271
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Entity Type | Individual
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Provider Name | TAYLOR LANTZY LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 5401 W 10TH ST STE 200
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City | GREELEY
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State | CO
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Zip | 80634-4468
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Country | US
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Telephone | 970-310-3406
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Fax |
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Provider Business Mailing Address
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Address Line | 5401 W 10TH ST STE 200
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City | GREELEY
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State | CO
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Zip | 80634-4468
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Country | US
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Telephone | 970-310-3406
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0002578
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License Number State | CO
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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 | CSW.09932588
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW.0009925112
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License Number State | CO
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