MEDICARE: STEPHANIE LYNN BIRNEY LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	LMSW14032	KS

General Provider Information

NPI Number	:	1023582814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE LYNN BIRNEY LMSW

Provider Business Mailing Address
First Line	:	6611 E CENTRAL AVE STE C
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-1937
Country	:	US
Telephone Number	:	316-688-2869
Fax Number	:

Provider Business Practice Location Address
First Line	:	6611 E CENTRAL AVE STE C
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-1937
Country	:	US
Telephone Number	:	316-688-2869
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	02/04/2026

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