Individual
CLINTON THAYNE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1001 W BROADWAY STE D, FARMINGTON, NM 87401-5638
(505) 325-0238
(505) 325-9113
Mailing address
1001 W BROADWAY STE D, FARMINGTON, NM 87401-5638
(505) 325-0238
(505) 325-9113
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0176141
NM
104100000X
Social Worker
M-09715
NM
104100000X
Social Worker
X-11195
NM
1041C0700X
Clinical Social Worker
Primary
C-11047
NM
Other
Enumeration date
01/25/2017
Last updated
04/02/2026
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