MEDICARE: MS. SHANNA LEAH TAYLOR LISW-S

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	I10168	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992928634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHANNA LEAH TAYLOR LISW-S

Provider Business Mailing Address
First Line	:	1 SEAGATE STE 800
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-1558
Country	:	US
Telephone Number	:	419-291-1801
Fax Number	:	419-882-8456

Provider Business Practice Location Address
First Line	:	1806 MADISON AVE FL 4
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-5460
Country	:	US
Telephone Number	:	419-291-1801
Fax Number	:	419-882-8456

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	11/03/2023

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Directions to “ MS. SHANNA LEAH TAYLOR LISW-S” Practice Location

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