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NPI Code Detail

MEDICARE: MRS. ANGELA MAE MCDANIEL LSCSW

MEDICARE: MRS. ANGELA MAE MCDANIEL LSCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker7519KS
21041C0700XClinical Social Worker4691KS

General Provider Information

NPI Number : 1033348305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA MAE MCDANIEL LSCSW
Provider Business Mailing Address
First Line : 7570 W. 21ST ST. NORTH
Second Line : BLDG 1050, STE E
City : WICHITA
State : KS
Zip : 67205
Country : US
Telephone Number : 316-285-0657
Fax Number : 316-260-9342
Provider Business Practice Location Address
First Line : 555 N WOODLAWN ST STE 3105
Second Line :
City : WICHITA
State : KS
Zip : 67208-3673
Country : US
Telephone Number : 316-681-1821
Fax Number : 316-685-0768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2009
Last Update Date : 07/10/2017

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