Provider Demographics
NPI:1669653374
Name:TAYLOR, MEG (LCSW)
Entity type:Individual
Prefix:
First Name:MEG
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGHEDI
Other - Middle Name:
Other - Last Name:EISAEIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27952 PARK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3598
Mailing Address - Country:US
Mailing Address - Phone:818-391-8806
Mailing Address - Fax:
Practice Address - Street 1:27952 PARK MEADOW DR
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-3598
Practice Address - Country:US
Practice Address - Phone:818-391-8806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA670131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical