Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Taylor Ross O'Connor

Individual provider Social Worker · NPI 1063047652

Taylor Ross O'Connor is a Clinical Social Worker in Jackson, Tennessee. Qualified in 2018, 8 years ago. Practices with Imind Mental Health and Wellness LLC, a 7-clinician group. Licensed in Tennessee.

Years since qualifying
8
Licensed in
TN
In the registry since
2020
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Practice location Address checks out

37 Sandstone Cir
Jackson, TN 38305-2089
Phone: (731) 265-6025
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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 12178 (TN)

Record details

NPI number1063047652
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 4, 2020
Last updated in NPPESMarch 4, 2020
Certification dateMarch 4, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Imind Mental Health And Wellness Llc — 7 clinicians
Accepts Medicare assignment Not indicated

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