Provider Demographics
NPI:1801653928
Name:CARTER, TAYLOR (LCSW)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:CARTER
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:N83W15861 STEVEN MACK CIR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-7601
Mailing Address - Country:US
Mailing Address - Phone:920-419-6984
Mailing Address - Fax:
Practice Address - Street 1:707 W MORELAND BLVD STE 7
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-2400
Practice Address - Country:US
Practice Address - Phone:262-217-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11633104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker