Provider Demographics
NPI:1366199549
Name:TAYLOR, HERMAN (LMSW)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 GRAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3110
Mailing Address - Country:US
Mailing Address - Phone:646-265-9051
Mailing Address - Fax:
Practice Address - Street 1:2280 GRAND AVE STE 310
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3110
Practice Address - Country:US
Practice Address - Phone:646-265-9051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical