MEDICARE: LAURYN GOODE

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
1	104100000X	Social Worker		KS

General Provider Information

NPI Number	:	1124981253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURYN GOODE

Provider Business Mailing Address
First Line	:	5318 LOOMAN ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-4020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5318 LOOMAN ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-4020
Country	:	US
Telephone Number	:	316-259-8057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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Directions to “ LAURYN GOODE ” Practice Location

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