Provider Demographics
NPI:1922735042
Name:TAYLOR, JANA C (MSW, LICSW, CPHQ)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:C
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSW, LICSW, CPHQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924-A ELLINGHAM CIR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315
Mailing Address - Country:US
Mailing Address - Phone:703-509-2178
Mailing Address - Fax:
Practice Address - Street 1:350 EASTERN AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2833
Practice Address - Country:US
Practice Address - Phone:202-248-1356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3002461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical