Provider Demographics
NPI:1063081370
Name:TAYLOR, ERIC DANTE' (LSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:DANTE'
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 BELDEN AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-1748
Mailing Address - Country:US
Mailing Address - Phone:330-410-2241
Mailing Address - Fax:
Practice Address - Street 1:12 E EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1519
Practice Address - Country:US
Practice Address - Phone:234-334-3293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1701689104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker