Provider Demographics
NPI:1518472992
Name:TAYLOR, JANET YVONNE (CADC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:YVONNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5344
Mailing Address - Country:US
Mailing Address - Phone:866-801-0085
Mailing Address - Fax:
Practice Address - Street 1:500 FAIR MEADOW DR
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-3209
Practice Address - Country:US
Practice Address - Phone:515-832-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16126101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)