Provider Demographics
NPI:1720229586
Name:TAYLOR, JILL (LCSW, CAC III)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 BURGUNDY DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8615
Mailing Address - Country:US
Mailing Address - Phone:720-339-5165
Mailing Address - Fax:
Practice Address - Street 1:9980 PARK MEADOWS DR
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6739
Practice Address - Country:US
Practice Address - Phone:303-339-9620
Practice Address - Fax:303-339-9621
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6445101YA0400X
CO5741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)