Healthcare Provider Details

I. General information

NPI: 1962961540
Provider Name (Legal Business Name): DIANE L GEISEN, LSCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114A S 7TH ST
SALINA KS
67401-2806
US

IV. Provider business mailing address

114A S 7TH ST
SALINA KS
67401-2806
US

V. Phone/Fax

Practice location:
  • Phone: 785-827-2700
  • Fax: 785-576-1199
Mailing address:
  • Phone: 785-827-2700
  • Fax: 785-576-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DIANE GEISEN
Title or Position: OWNER/PRACTITIONER
Credential: LSCSW
Phone: 785-827-2700