Healthcare Provider Details

I. General information

NPI: 1649360744
Provider Name (Legal Business Name): GAYLE ELAINE EDWARDS LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GAYLE ELAINE STEGMAN LSCSW

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 HOUSTON ST
MANHATTAN KS
66502-6169
US

IV. Provider business mailing address

423 HOUSTON STREET
MANHATRAN KS
67502-4271
US

V. Phone/Fax

Practice location:
  • Phone: 785-547-4346
  • Fax:
Mailing address:
  • Phone: 785-587-4345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1976
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: