Provider Demographics
NPI:1013253939
Name:TAYLOR, ANASTASIA CHRISTINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:CHRISTINA
Last Name:TAYLOR
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 1:6051 DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6385
Mailing Address - Country:US
Mailing Address - Phone:469-826-1456
Mailing Address - Fax:
Practice Address - Street 1:2401 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-2228
Practice Address - Country:US
Practice Address - Phone:817-851-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX525861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical