Kristina Michelle Taylor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

56640 Issued in TX

Practice address

5415 Sugarloaf Pkwy Ste 11085489
Lawrenceville, GA 30043-7832

Phone

(478) 295-3414

NPI assigned

Nov 8, 2017

Sex

Female

Sole proprietor

Yes

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)

Enrolled

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.

• Cedar Creek Wellness Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Gun Barrel City, TX
  • NPI 1922648310
  NPD (past)
• East Texas Neurobehavioral Health,PLLC

  • Clinical Psychologist
  • Gun Barrel City, TX
  • NPI 1114285970
  NPD (past)

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1609389089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 SUGARLOAF PKWY STE 11085489",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437832",
            "telephone_number": "478-295-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 SUGARLOAF PKWY STE 11085489",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437832",
            "telephone_number": "478-295-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KRISTINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daviea Antoinette Taylor-Hicks, PA-C
• Adaky Chidundo Taylor, PA-C
• Charmion Lynell Taylor
• Colleen Taylor, PHD
• Darcey Jerome Taylor, DMD
• Leslie Inez Taylor, PCT
• Lorna Elica Taylor, LPC
• Precious E Taylor
• Regina Taylor
• Teyana Taylor

• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.