MEDICARE: ERIN TAYLOR GOODNESS LMSW

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	104100000X	Social Worker	096794	NY
2	1041C0700X	Clinical Social Worker	088002	NY

General Provider Information

NPI Number	:	1497219695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN TAYLOR GOODNESS LMSW

Provider Business Mailing Address
First Line	:	406 TARRINGTON RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14609-5716
Country	:	US
Telephone Number	:	585-406-7701
Fax Number	:

Provider Business Practice Location Address
First Line	:	406 TARRINGTON RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14609-5716
Country	:	US
Telephone Number	:	585-406-7701
Fax Number	:

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

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	02/06/2023

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