Provider Demographics
NPI:1255860920
Name:TAYLOR, JAIME HELLEN (LMSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:HELLEN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 BROOKHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3626
Mailing Address - Country:US
Mailing Address - Phone:718-869-8400
Mailing Address - Fax:844-310-8401
Practice Address - Street 1:1908 BROOKHAVEN AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3626
Practice Address - Country:US
Practice Address - Phone:718-869-8400
Practice Address - Fax:844-310-8401
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0971171104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker