Provider Demographics
NPI:1932655578
Name:DUFFY, TAYLAR (MSW,LCSWA,LCASA)
Entity Type:Individual
Prefix:MRS
First Name:TAYLAR
Middle Name:
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MSW,LCSWA,LCASA
Other - Prefix:
Other - First Name:TAYLAR
Other - Middle Name:
Other - Last Name:INGERSOLL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:607 WICKER ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4151
Mailing Address - Country:US
Mailing Address - Phone:919-895-8598
Mailing Address - Fax:919-964-3374
Practice Address - Street 1:607 WICKER ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4151
Practice Address - Country:US
Practice Address - Phone:919-895-8598
Practice Address - Fax:919-964-3374
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0107411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical