Provider Demographics
NPI:1790377828
Name:TAYLOR, JAMIE RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:RENEE
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 1:4411 HUEBNER LN
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-9625
Mailing Address - Country:US
Mailing Address - Phone:812-746-8498
Mailing Address - Fax:
Practice Address - Street 1:12021 NORTHFACE DR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-9412
Practice Address - Country:US
Practice Address - Phone:317-253-7387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical