Cornelliss Taylor, MSW, ACSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW82059 Issued in CA

Practice address

250 Bon Air Rd Unit B
Greenbrae, CA 94904-1702

Phone

(415) 473-6666

NPI assigned

Aug 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of Marin

  • Community/Behavioral Health Agency
  • Greenbrae, CA
  • NPI 1962839803
  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1477034056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 WASHINGTON AVE 474",
            "address_2": "SAN LEANDRO, CA 94577",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94577",
            "telephone_number": "510-820-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD UNIT B",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-473-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "386 14th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946123211",
            "country_code": "US",
            "telephone_number": "510-250-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CORNELLISS",
        "credential": "MSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW82059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azita Taghavy, M.D.
• Tamalpais Speech and Feeding Therapy, Inc
• Cheryl Ann Tanasovich, M.D.
• David Fonseca Tapia, ATC, EMT
• Blake E. S. Taylor, MD
• Robert Daniel Teasdale Jr., M.D.
• Sima Tei
• William Lockwood Teufel, MD
• Lillian Vy Thai
• Thomas P. Collins, DDS, a PC

• Mental Health Counselor in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.