Provider Demographics
NPI:1386235406
Name:MULLEN, TAYLOR ANNE (MSSW, LSW)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANNE
Last Name:MULLEN
Suffix:
Gender:F
Credentials:MSSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 EASTERN AVE # 0
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-4450
Mailing Address - Country:US
Mailing Address - Phone:513-341-8738
Mailing Address - Fax:
Practice Address - Street 1:4855 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-4450
Practice Address - Country:US
Practice Address - Phone:873-851-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY255298104100000X
OHS.2105882104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker