Provider Demographics
NPI:1649634064
Name:TAYLOR, KAREN NICOLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:NICOLE
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 1:20 W MOSHOLU PKWY S APT 26J
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-1153
Mailing Address - Country:US
Mailing Address - Phone:347-968-1908
Mailing Address - Fax:
Practice Address - Street 1:20 W MOSHOLU PKWY S APT 26J
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-1153
Practice Address - Country:US
Practice Address - Phone:347-968-1908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093329104100000X
NY0894211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker