MEDICARE: TAYLOR SHEAR LISW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.2002102-SUPV	OH

General Provider Information

NPI Number	:	1215426051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR SHEAR LISW

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7250 POE AVE # 220
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-2687
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	08/05/2025

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