Justin Michael Taylor I, LICENSED MSW

NPI #1992455398 in Lake Ronkonkoma, New York

Provider Information

NPI Number: 1992455398
Entity Type: Individual
Name: Justin Michael Taylor I, LICENSED MSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LICENSED MSW
Enumeration Date: Mar 28, 2022
Last Updated: Jan 2, 2026

Practice Location

Address: 153 LAKE SHORE RD
City: Lake Ronkonkoma
State: New York
ZIP Code: 11779-3193
Phone: (631) 471-5666

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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