Provider Demographics
NPI:1417679614
Name:TAYLOR, SARA (LMSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:TAYLOR-NIEMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW, MSW-APSW
Mailing Address - Street 1:2620 STEIN BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-2674
Mailing Address - Country:US
Mailing Address - Phone:715-836-0064
Mailing Address - Fax:715-836-0065
Practice Address - Street 1:2620 STEIN BLVD
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-2672
Practice Address - Country:US
Practice Address - Phone:715-836-0064
Practice Address - Fax:715-836-0065
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7559T104100000X
WI134700-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker