Provider Demographics
NPI:1215456843
Name:SMITH, TAYLOR N (MSW, LISW)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:N
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:N
Other - Last Name:LESHESKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2980 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1834
Mailing Address - Country:US
Mailing Address - Phone:330-759-2310
Mailing Address - Fax:330-759-0018
Practice Address - Street 1:2980 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1834
Practice Address - Country:US
Practice Address - Phone:330-759-2310
Practice Address - Fax:330-759-0018
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.18023911041C0700X
OHI.21030091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty