Provider Demographics
NPI:1710717517
Name:TAYLOR-WILLIAMS, TERESA CATHLEEN (LMSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:CATHLEEN
Last Name:TAYLOR-WILLIAMS
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 1:514 N DODGE AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-5905
Mailing Address - Country:US
Mailing Address - Phone:316-330-3297
Mailing Address - Fax:
Practice Address - Street 1:514 N DODGE AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-5905
Practice Address - Country:US
Practice Address - Phone:316-330-3297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13751104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker