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General NPI Number Information
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NPI Number | 1083693956
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Entity Type | Individual
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Provider Name | STEPHENIE ANN ROBERTS LSCSW
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Gender | Female
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 9505 W. CENTRAL STE. 103
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City | WICHITA
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State | KS
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Zip | 67212-3832
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Country | US
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Telephone | 316-721-0971
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Fax | 316-512-4070
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Provider Business Mailing Address
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Address Line | 9505 W CENTRAL AVE STE. 103
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City | WICHITA
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State | KS
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Zip | 67212-3801
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Country | US
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Telephone | 316-721-0971
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Fax | 316-512-4070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1949
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License Number State | KS
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