Healthcare Provider Details

I. General information

NPI: 1659134633
Provider Name (Legal Business Name): LILLIAN NYAKAIRU MAINA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 N MAIN ST
WICHITA KS
67203-3602
US

IV. Provider business mailing address

1001 LYNCH ST
SAINT LOUIS MO
63118-1818
US

V. Phone/Fax

Practice location:
  • Phone: 316-660-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2024003650
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW14021
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: