Shanda Lynette Boling-Taylor, MSW
Individual provider Active NPI Social Worker · Mount Vernon, IL
NPI 1164091377 · NPPES record last updated Jun 22, 2021
Key facts
- NPI
- 1164091377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 403 N 42ND St Ste C
Mount Vernon, IL 62864-2297 - Phone
- (618) 283-2222
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic, Education, and Career Services, Inc. | Social Worker | Current |
Accepting new patients |
Locations
403 N 42nd St
Ste C
Mount Vernon, IL 62864
Phone (618) 242-1070
1121 N 6th St
Vandalia, IL 62471
Phone (618) 283-2222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
403 N 42ND St Ste C
Mount Vernon, IL 62864-2297
Mailing address
1121 N 6TH St
Vandalia, IL 62471-1219
Phone (618) 283-2222
Other providers in Mount Vernon, IL
- Curtis William Boehne
- Olivia Boehnke
- Michele L Boester
- Brittney Boldt
- Faye Boldwyn-Stephens
- Rhian Boling
- Crystal Lynn Bollman
- Christie Bond
- Cynthia Booher
- Borowiak Iga Foodliner Inc
All providers in Mount Vernon, IL · Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.