Provider Demographics
NPI:1841806635
Name:TAYLOR, BRIANNA MARIE-MCCALL (LASW)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE-MCCALL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18119 126TH AVE NE APT 412
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-9331
Mailing Address - Country:US
Mailing Address - Phone:951-852-3685
Mailing Address - Fax:
Practice Address - Street 1:3025 112TH AVE NE STE A-120
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-8000
Practice Address - Country:US
Practice Address - Phone:425-275-2918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASWAA.SA.61201368104100000X
DCLG50083312104100000X
WASWA.LW.61223514104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker