Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin Michael Taylor I, LICENSEDMSW

Individual provider Social Worker · NPI 1992455398

Justin Michael Taylor I, LICENSEDMSW is a Social Worker in Lake Ronkonkoma, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2022
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Practice location Address checks out

153 Lake Shore Rd
Lake Ronkonkoma, NY 11779-3193
Phone: (631) 471-5666
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 104733-01 (NY)

Record details

NPI number1992455398
Entity typeIndividual (Type 1)
GenderMale
Credentials LICENSEDMSW
Sole proprietorYes
NPI enumeratedMarch 28, 2022
Last updated in NPPESJanuary 2, 2026
Certification dateJanuary 2, 2026

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