Provider Demographics
NPI:1699277822
Name:TAYLOR, CURTISHA RENEE (LCSW)
Entity type:Individual
Prefix:
First Name:CURTISHA
Middle Name:RENEE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 ROCKCREEK PL APT 6
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-7560
Mailing Address - Country:US
Mailing Address - Phone:630-532-3614
Mailing Address - Fax:
Practice Address - Street 1:8210 ROCKCREEK PL APT 6
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-7560
Practice Address - Country:US
Practice Address - Phone:630-532-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN65861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical