Provider Demographics
NPI:1699019703
Name:TAYLOR, CAROL H (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:H
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 1:1400 BUFORD HWY STE G7
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8727
Mailing Address - Country:US
Mailing Address - Phone:229-251-2391
Mailing Address - Fax:678-228-1977
Practice Address - Street 1:1400 BUFORD HWY STE G7
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-8727
Practice Address - Country:US
Practice Address - Phone:229-251-2391
Practice Address - Fax:678-228-1977
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0039091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical