Provider Demographics
NPI:1013106400
Name:TAYLOR-MUSOKE, TAMMY L (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:TAYLOR-MUSOKE
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:PO BOX 11247
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1247
Mailing Address - Country:US
Mailing Address - Phone:804-497-4676
Mailing Address - Fax:804-497-4677
Practice Address - Street 1:5014 MONUMENT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3620
Practice Address - Country:US
Practice Address - Phone:804-497-4676
Practice Address - Fax:804-497-4677
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical