Provider Demographics
NPI:1699741264
Name:TAYLOR-FORD, GAYLE M (LSCSW, LCAC)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:M
Last Name:TAYLOR-FORD
Suffix:
Gender:F
Credentials:LSCSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 KENNEDY ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-1120
Mailing Address - Country:US
Mailing Address - Phone:620-364-2606
Mailing Address - Fax:620-364-2551
Practice Address - Street 1:1200 GRAPHIC ARTS RD STE 100
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6204
Practice Address - Country:US
Practice Address - Phone:620-208-6480
Practice Address - Fax:620-364-2551
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS41941041C0700X
KS410101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003878840007Medicaid
KS30003878840001Medicaid
KS30003878840002Medicaid
KS30003878840006Medicaid
KS0000116078OtherBC/BS KANSAS