Provider Demographics
NPI:1093225062
Name:HENDERSON-HOOD, TAYLOR ANN (LICSW, MSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:HENDERSON-HOOD
Suffix:
Gender:F
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 MINOTAUR CIR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-8215
Mailing Address - Country:US
Mailing Address - Phone:916-467-0713
Mailing Address - Fax:
Practice Address - Street 1:4229 MINOTAUR CIR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-8215
Practice Address - Country:US
Practice Address - Phone:916-467-0713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60846356101Y00000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor