MEDICARE: MR. TAYLOR JORDAN AVERY MSW, 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
1	1041C0700X	Clinical Social Worker	108620	TX

General Provider Information

NPI Number	:	1790466274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAYLOR JORDAN AVERY MSW, LCSW

Provider Business Mailing Address
First Line	:	2800 CARMEL ST
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-8310
Country	:	US
Telephone Number	:	214-476-6511
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 CARMEL ST
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-8310
Country	:	US
Telephone Number	:	214-477-6651
Fax Number	:

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

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	04/06/2026

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