Provider Demographics
NPI:1851588032
Name:TAYLOR, ALLISON STACIA (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:STACIA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 S 188TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-5070
Mailing Address - Country:US
Mailing Address - Phone:206-901-1685
Mailing Address - Fax:
Practice Address - Street 1:4040 S 188TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-5070
Practice Address - Country:US
Practice Address - Phone:206-901-1685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60667353104100000X, 1041C0700X
OR47361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker