Individual
MACKENZIE L TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1655 HUDSON ST STE 5, LONGVIEW, WA 98632-2949
(503) 926-9413
(360) 967-8030
Mailing address
1655 HUDSON ST STE 5, LONGVIEW, WA 98632-2949
(503) 926-9413
(360) 967-8030
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LW60495001
WA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/11/2009
Last updated
05/07/2019
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