Healthcare Provider Details

I. General information

NPI: 1609163583
Provider Name (Legal Business Name): ANTHONY KITCHEN LMSW, LMAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 07/09/2022
Certification Date: 07/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E 1ST ST
NEWTON KS
67114-5010
US

IV. Provider business mailing address

1901 E 1ST ST PO BOX 467
NEWTON KS
67114-0467
US

V. Phone/Fax

Practice location:
  • Phone: 316-284-6400
  • Fax: 316-284-6490
Mailing address:
  • Phone: 316-284-6400
  • Fax: 316-284-6490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number705
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10322
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: