Provider Demographics
NPI:1598826760
Name:TAYLOR, MARIANNE SCHUSTER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:SCHUSTER
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 1:2100 GARDINER LN
Mailing Address - Street 2:316-A
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2962
Mailing Address - Country:US
Mailing Address - Phone:502-479-0038
Mailing Address - Fax:502-485-9392
Practice Address - Street 1:2100 GARDINER LN
Practice Address - Street 2:316-A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2962
Practice Address - Country:US
Practice Address - Phone:502-479-0038
Practice Address - Fax:502-485-9392
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY08621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000345923OtherANTHEM
KYCSW0286Medicare ID - Type UnspecifiedPROVIDER NUMBER