Provider Demographics
NPI:1326639634
Name:TAYLOR, KATHRYN ALLYSON (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ALLYSON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ELM AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4001
Mailing Address - Country:US
Mailing Address - Phone:540-266-9200
Mailing Address - Fax:540-266-9207
Practice Address - Street 1:611 MCDOWELL AVE NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-1225
Practice Address - Country:US
Practice Address - Phone:540-266-9200
Practice Address - Fax:540-266-9207
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical