Provider Demographics
NPI:1508106915
Name:TAYLOR, ROBIN NOEL (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:NOEL
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 1:108 RIVERBIRCH CIR
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQ
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1678
Mailing Address - Country:US
Mailing Address - Phone:610-306-8981
Mailing Address - Fax:
Practice Address - Street 1:3314 OLD CAPITOL TRL
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-6235
Practice Address - Country:US
Practice Address - Phone:610-306-8981
Practice Address - Fax:302-516-7672
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0193981041C0700X
DEQ1-00012031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1083804Medicaid