Healthcare Provider Details

I. General information

NPI: 1962711242
Provider Name (Legal Business Name): LINDSAY NICOLE SANNER LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 S ANDOVER RD STE 100
ANDOVER KS
67002-7935
US

IV. Provider business mailing address

149 S ANDOVER RD STE 100
ANDOVER KS
67002-7935
US

V. Phone/Fax

Practice location:
  • Phone: 316-247-3063
  • Fax: 316-247-6833
Mailing address:
  • Phone: 316-247-3063
  • Fax: 316-247-6833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7777
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4562
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: