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NPI Code Detail

MEDICARE: CASSIDY TAYLOR LCSW

MEDICARE: CASSIDY TAYLOR LCSW
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1639483118
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIDY TAYLOR LCSW
Provider Business Mailing Address
First Line : 208 RACQUETTE DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4851
Country : US
Telephone Number : 970-795-0601
Fax Number :
Provider Business Practice Location Address
First Line : 208 RACQUETTE DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4851
Country : US
Telephone Number : 970-795-0601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2010
Last Update Date : 06/06/2023

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Directions to “ CASSIDY TAYLOR LCSW” Practice Location

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