Healthcare Provider Details

I. General information

NPI: 1194132209
Provider Name (Legal Business Name): COLEEN D KIDD LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SW 3RD ST UNIT 1A
TOPEKA KS
66606-2438
US

IV. Provider business mailing address

7300 SW CANNOCK CHASE RD
TOPEKA KS
66614-1534
US

V. Phone/Fax

Practice location:
  • Phone: 785-270-4600
  • Fax: 785-270-4628
Mailing address:
  • Phone: 785-213-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4275
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4275
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: