Provider Demographics
NPI:1609851633
Name:TAYLOR HUEY, ELIZABETH L (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:TAYLOR HUEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:L
Other - Last Name:SUMNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 S WASHINGTON AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-3814
Mailing Address - Country:US
Mailing Address - Phone:570-591-5159
Mailing Address - Fax:570-343-3923
Practice Address - Street 1:440 N MAIN ST
Practice Address - Street 2:D
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4990
Practice Address - Country:US
Practice Address - Phone:860-314-2052
Practice Address - Fax:860-314-2054
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004342104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004195732Medicaid