Healthcare Provider Details

I. General information

NPI: 1346174331
Provider Name (Legal Business Name): LEAH JO MAXFIELD LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 W 15TH ST
PLEASANTON KS
66075-4095
US

IV. Provider business mailing address

1106 S 9TH ST
HUMBOLDT KS
66748-1934
US

V. Phone/Fax

Practice location:
  • Phone: 913-352-8214
  • Fax: 913-352-8236
Mailing address:
  • Phone: 620-473-2241
  • Fax: 620-473-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14711
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: