Healthcare Provider Details

I. General information

NPI: 1174120257
Provider Name (Legal Business Name): PAIGE GUMPENBERGER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 N HIGH ST
WICHITA KS
67203-4363
US

IV. Provider business mailing address

903 S EDGEMOOR ST
WICHITA KS
67218-3337
US

V. Phone/Fax

Practice location:
  • Phone: 316-973-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number12019
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: