Individual
MR. CHARLES JOSEPH TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW, CASAC-T
Contact information
Practice address
25 CHAPEL ST STE 604, BROOKLYN, NY 11201-1916
(718) 630-2830
Mailing address
6591 TERRACE CT # 3, MIDDLE VILLAGE, NY 11379-1632
(757) 287-3632
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
33461
NY
104100000X
Social Worker
Primary
098988-1
NY
Other
Enumeration date
06/30/2017
Last updated
04/18/2018
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