Individual provider Active NPI

Taylor Willard, LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1003638412
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34011492A Issued in IN
Practice address
7409 Eagle Crest Blvd
Evansville, IN 47715-9136
Phone
(812) 426-9779
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34011492A IN Primary

Addresses

Primary practice location

7409 Eagle Crest Blvd
Evansville, IN 47715-9136

Mailing address

7409 Eagle Crest Blvd
Evansville, IN 47715-9136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250122001876 IN Practitioner - Clinical Social Worker 3870022783 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Current Accepting new patients
Deaconess Clinic Inc CurrentSince Nov 22, 2024 Accepting new patients
Deaconess Hospital Inc Clinical CurrentSince Feb 1, 2025 Accepting new patients
Deaconess Hospital, Inc Clinical CurrentSince Feb 1, 2025 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic, Inc. CurrentSince Nov 22, 2024 Accepting new patients

Locations

445 N Cross Pointe Blvd
Evansville, IN 47715
Phone (812) 402-2003

7409 Eagle Crest Blvd
Ste G
Evansville, IN 47715
Phone (812) 774-8919

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

7200 E Indiana St
Evansville, IN 47715
Phone (812) 476-7200

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1003638412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7409 EAGLE CREST BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7409 EAGLE CREST BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159136",
            "telephone_number": "812-426-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "TAYLOR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34011492A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.