Individual
KELLY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, LCSW
Contact information
Practice address
9 COVEY RD, 2AF, BURLINGTON, CT 06013-1720
(860) 259-4442
Mailing address
9 COVEY RD, 2AF, BURLINGTON, CT 06013-1720
(860) 259-4442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1166
CT
1041C0700X
Clinical Social Worker
Primary
9915
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008067986
—
CT
Enumeration date
02/02/2016
Last updated
07/21/2022
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