Healthcare Provider Details

I. General information

NPI: 1548082290
Provider Name (Legal Business Name): KLOEY RAYANN LE LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KLOEY RAYANN BROWN LSCSW

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8623 E 32ND ST N
WICHITA KS
67226-3317
US

IV. Provider business mailing address

1519 MERCHANT ST
EMPORIA KS
66801-5005
US

V. Phone/Fax

Practice location:
  • Phone: 316-869-2888
  • Fax:
Mailing address:
  • Phone: 620-343-2211
  • Fax: 620-342-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number07209
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: