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General NPI Number Information
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NPI Number | 1487989893
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Entity Type | Individual
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Provider Name | DARCY ELAINE BLOOMQUIST LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/03/2009
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 266 N MAIN ST STE 150
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City | WICHITA
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State | KS
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Zip | 67202-1516
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Country | US
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Telephone | 316-305-2964
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Fax |
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Provider Business Mailing Address
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Address Line | 2053 S RIDGEWOOD DR
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City | WICHITA
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State | KS
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Zip | 67218-5235
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Country | US
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Telephone | 316-371-2965
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7471
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License Number State | KS
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Taxonomy #2
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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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