Provider Demographics
NPI:1609189307
Name:TERRY-TAYLOR, RAYNA E (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYNA
Middle Name:E
Last Name:TERRY-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 1:17 ALABAMA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7210
Mailing Address - Country:US
Mailing Address - Phone:516-457-2353
Mailing Address - Fax:
Practice Address - Street 1:90-27 SUTPHIN BLVD, 5TH FLOOR
Practice Address - Street 2:TRANSITIONAL SERVICES OF NEW YORK
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435
Practice Address - Country:US
Practice Address - Phone:718-526-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0518891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical