Provider Demographics
NPI:1952021933
Name:SPANN TAYLOR, PARTAJA NIQUA (LCSW)
Entity type:Individual
Prefix:MS
First Name:PARTAJA
Middle Name:NIQUA
Last Name:SPANN 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 CALEF ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-7138
Mailing Address - Country:US
Mailing Address - Phone:401-999-7495
Mailing Address - Fax:
Practice Address - Street 1:460 PINE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1358
Practice Address - Country:US
Practice Address - Phone:401-272-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical