Provider Demographics
NPI:1023572740
Name:BARRERA, TAYLOR A (LCSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:A
Last Name:BARRERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:TAYLOR
Other - Middle Name:ANNE
Other - Last Name:BARRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:923 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-4137
Mailing Address - Country:US
Mailing Address - Phone:208-371-6908
Mailing Address - Fax:
Practice Address - Street 1:123 N YALE ST
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-2340
Practice Address - Country:US
Practice Address - Phone:208-585-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-27
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-37704261QM0801X
IDLCSW-429381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)