Provider Demographics
NPI:1184354193
Name:TAYLOR, MADISON SANDIFER (LCSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:SANDIFER
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 1:2000 S DAIRY ASHFORD RD STE 660
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5711
Mailing Address - Country:US
Mailing Address - Phone:205-292-3588
Mailing Address - Fax:
Practice Address - Street 1:2000 S DAIRY ASHFORD RD STE 660
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5711
Practice Address - Country:US
Practice Address - Phone:205-292-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical