Provider Demographics
NPI:1497528194
Name:BROWN, TAYLOR RAE (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 COOVER RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9720
Mailing Address - Country:US
Mailing Address - Phone:937-926-4711
Mailing Address - Fax:
Practice Address - Street 1:78 VILLAGE POINTE DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7760
Practice Address - Country:US
Practice Address - Phone:614-329-8862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2208292104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker