=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891071049
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLIE LEANNE TAYLOR L.M.S.W.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2011
-----------------------------------------------------
Last Update Date | 01/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1210 W SAGINAW ST SUBSTANCE ABUSE UNIT
-----------------------------------------------------
City | LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48915-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-364-7740
-----------------------------------------------------
Fax | 517-364-7744
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1210 W SAGINAW ST SUBSTANCE ABUSE UNIT
-----------------------------------------------------
City | LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48915-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-364-7740
-----------------------------------------------------
Fax | 517-364-7744
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 6801089391
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------