Provider Demographics
NPI:1497900997
Name:TAYLOR, LORELEY JOY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LORELEY
Middle Name:JOY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 SCOTS PL E
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-8315
Mailing Address - Country:US
Mailing Address - Phone:910-547-7270
Mailing Address - Fax:
Practice Address - Street 1:3906 SCOTS PL E
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-8315
Practice Address - Country:US
Practice Address - Phone:910-547-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0047981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical