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General NPI Number Information
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NPI Number | 1285744938
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Entity Type | Individual
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Provider Name | JOHN FRANCIS THEIS LSCSW
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23 E 1ST AVE SUITE #4
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City | HUTCHINSON
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State | KS
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Zip | 67501-7146
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Country | US
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Telephone | 620-662-6658
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Fax |
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Provider Business Mailing Address
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Address Line | 311 E FOREST AVE
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City | SOUTH HUTCHINSON
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State | KS
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Zip | 67505-2025
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Country | US
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Telephone | 620-662-6658
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSCSW 1404
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License Number State | KS
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