Provider Demographics
NPI:1962924456
Name:TAYLOR, ROBIN MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:MARIE
Other - Last Name:AHLGREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3880 SOUTH WASHINGTON AVE
Mailing Address - Street 2:SUITE 238
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780
Mailing Address - Country:US
Mailing Address - Phone:321-735-8113
Mailing Address - Fax:833-921-0180
Practice Address - Street 1:3880 SOUTH WASHINGTON AVE
Practice Address - Street 2:SUITE 238
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780
Practice Address - Country:US
Practice Address - Phone:321-735-8113
Practice Address - Fax:833-921-0180
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW130701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical