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General NPI Number Information
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NPI Number | 1326499237
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Entity Type | Organization
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Legal Business Name | HEATHER L. HOLCOMB, LSCSW, LLC
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Dates
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Enumeration Date | 06/22/2016
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 8100 E 22ND ST N BUILDING 100 SUITE 2
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City | WICHITA
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State | KS
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Zip | 67226-2388
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Country | US
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Telephone | 316-300-5787
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Fax | 316-337-5481
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Provider Business Mailing Address
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Address Line | 8100 E 22ND ST N BUILDING 100 SUITE 2
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City | WICHITA
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State | KS
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Zip | 67226-2388
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Country | US
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Telephone | 316-300-5787
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Fax | 316-337-5481
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER L HOLCOMB
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Credential | LSCSW
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Telephone | 316-300-5787
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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 | 2259
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License Number State | KS
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