Provider Demographics
NPI:1285247890
Name:TAYLOR, DANA ADAIR (LCSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:ADAIR
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:A
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:727 E ETNA RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-1040
Mailing Address - Country:US
Mailing Address - Phone:815-434-4727
Mailing Address - Fax:
Practice Address - Street 1:727 E ETNA RD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-1040
Practice Address - Country:US
Practice Address - Phone:815-434-4727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0262621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty