Provider Demographics
NPI:1598389959
Name:TAYLOR, PAIGE GABRIELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:GABRIELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 FRANKFORT AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2639
Mailing Address - Country:US
Mailing Address - Phone:502-893-0241
Mailing Address - Fax:502-212-1289
Practice Address - Street 1:2823 FRANKFORT AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2639
Practice Address - Country:US
Practice Address - Phone:502-893-0241
Practice Address - Fax:502-212-1289
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2548301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical