Provider Demographics
NPI:1730899766
Name:TAYLOR, JANELL A (LCSW)
Entity type:Individual
Prefix:
First Name:JANELL
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E TWOHIG AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6433
Mailing Address - Country:US
Mailing Address - Phone:325-944-2561
Mailing Address - Fax:325-653-4218
Practice Address - Street 1:5419 N LOVINGTON HWY STE 24
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-9135
Practice Address - Country:US
Practice Address - Phone:575-249-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2023-0136104100000X
TX1090261041C0700X
NMSWB-2024-11971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker