Provider Demographics
NPI:1003301078
Name:BAINTER, TAYLOR ROSE (LSCSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ROSE
Last Name:BAINTER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 462
Mailing Address - Street 2:
Mailing Address - City:HOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:67740-0462
Mailing Address - Country:US
Mailing Address - Phone:913-703-6223
Mailing Address - Fax:
Practice Address - Street 1:1124 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:KS
Practice Address - Zip Code:67740-4295
Practice Address - Country:US
Practice Address - Phone:137-036-2239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10906104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker