Provider Demographics
NPI:1326224403
Name:TAYLOR, MARJORIE (LICSW)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W CORNWALL RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-2100
Mailing Address - Country:US
Mailing Address - Phone:860-387-3347
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST
Practice Address - Street 2:UNIT # 5
Practice Address - City:SOUTH EGREMONT
Practice Address - State:MA
Practice Address - Zip Code:01258-9706
Practice Address - Country:US
Practice Address - Phone:860-347-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker