Provider Demographics
NPI:1366015992
Name:TAYLOR, SUZANNE (LCSW, CRAADC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW, CRAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13340 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64145-1437
Mailing Address - Country:US
Mailing Address - Phone:913-220-9895
Mailing Address - Fax:816-599-7510
Practice Address - Street 1:13340 HOLMES RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64145-1437
Practice Address - Country:US
Practice Address - Phone:913-220-9895
Practice Address - Fax:816-599-7510
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170348381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical