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General NPI Number Information
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NPI Number | 1871095596
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Entity Type | Organization
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Legal Business Name | BETHANY A. OWENS, LSCSW
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 400 N WOODLAWN ST STE 30
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City | WICHITA
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State | KS
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Zip | 67208-4333
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Country | US
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Telephone | 316-612-9223
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Fax | 316-612-9223
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Provider Business Mailing Address
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Address Line | PO BOX 17053
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City | WICHITA
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State | KS
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Zip | 67217-0053
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Country | US
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Telephone | 316-944-3940
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Fax | 316-946-0694
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. LORRY A SWAYZE
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Credential |
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Telephone | 316-944-3940
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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 | 4768
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License Number State | KS
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