Provider Demographics
NPI:1932833886
Name:TAYLOR, RASHEEDAH CARROLETT (LCSW)
Entity type:Individual
Prefix:
First Name:RASHEEDAH
Middle Name:CARROLETT
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 1:2824 CORPREW AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-4004
Mailing Address - Country:US
Mailing Address - Phone:757-672-0389
Mailing Address - Fax:
Practice Address - Street 1:2824 CORPREW AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-4004
Practice Address - Country:US
Practice Address - Phone:757-672-0389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040130591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical