National Provider Identifier

Traci Davis-Taylor, LCSW

Traci Davis-Taylor, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Brockport, NY and a listed phone number of (716) 940-9109.

NPI 1598385437Brockport, NYClinical Social Worker

Profile Overview

NPI
1598385437
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
April 21, 2020
Last Updated
April 21, 2020

Practice Location

  • 122 Viking Way
  • Brockport, NY 14420-2405

Phone: (716) 940-9109

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1598385437
Entity Type
Individual
Last Name
Davis-Taylor
First Name
Traci
Credential
LCSW
Mailing Street Address
122 Viking Way
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-2405
Mailing Country
US
Mailing Phone
(716) 940-9109
Practice Street Address
122 Viking Way
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-2405
Practice Country
US
Practice Phone
(716) 940-9109
Enumeration Date
April 21, 2020
Last Updated
April 21, 2020
Sex
Female
Sole Proprietor
Yes
Certification Date
April 21, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)