Provider Demographics
NPI:1982155032
Name:YOUNG, TAYLOR K (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 WASHINGTON ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02131-1747
Mailing Address - Country:US
Mailing Address - Phone:508-277-6800
Mailing Address - Fax:
Practice Address - Street 1:1685 BEACON ST STE 1C
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-4411
Practice Address - Country:US
Practice Address - Phone:617-467-4136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002219411041C0700X
MA1215151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical