Provider Demographics
NPI:1124395884
Name:TAYLOR, ADRIENNE ERICA (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:ERICA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 BLUE RIDGE CUTOFF
Mailing Address - Street 2:SUITE 312
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133
Mailing Address - Country:US
Mailing Address - Phone:816-425-2850
Mailing Address - Fax:
Practice Address - Street 1:6220 BLUE RIDGE CUTOFF
Practice Address - Street 2:SUITE 312
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-3700
Practice Address - Country:US
Practice Address - Phone:816-425-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050151211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical