MEDICARE: TAYLOR MARIE LACOUTURE MSW, LCSWA

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	P020212	NC

General Provider Information

NPI Number	:	1326906751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR MARIE LACOUTURE MSW, LCSWA

Provider Business Mailing Address
First Line	:	231 COMMERCE ST
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5029
Country	:	US
Telephone Number	:	252-321-8080
Fax Number	:	252-321-7999

Provider Business Practice Location Address
First Line	:	231 COMMERCE ST
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5029
Country	:	US
Telephone Number	:	252-321-8080
Fax Number	:	252-321-7999

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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