Provider Demographics
NPI:1619860533
Name:TAYLOR, EBONI (LMSW)
Entity type:Individual
Prefix:
First Name:EBONI
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24002 COLONIAL PKWY APT 2107
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3991
Mailing Address - Country:US
Mailing Address - Phone:337-349-4634
Mailing Address - Fax:
Practice Address - Street 1:24002 COLONIAL PKWY APT 2107
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3991
Practice Address - Country:US
Practice Address - Phone:337-349-4634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111128104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker