Healthcare Provider Details

I. General information

NPI: 1245744135
Provider Name (Legal Business Name): SHARON KAY BIRTELL LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3242 SE STANLEY RD
TECUMSEH KS
66542-9631
US

IV. Provider business mailing address

3242 SE STANLEY RD
TECUMSEH KS
66542-9631
US

V. Phone/Fax

Practice location:
  • Phone: 785-633-3887
  • Fax:
Mailing address:
  • Phone: 785-640-1149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5285
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: