Healthcare Provider Details

I. General information

NPI: 1861639007
Provider Name (Legal Business Name): SUSAN SCHLAG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2009
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 1ST TER STE 220F
LANSING KS
66043-1715
US

IV. Provider business mailing address

18162 STILLWELL RD
LINWOOD KS
66052-4547
US

V. Phone/Fax

Practice location:
  • Phone: 913-717-9906
  • Fax: 310-507-0157
Mailing address:
  • Phone: 619-517-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT52046
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLCMFT2880
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: