MEDICARE: BETHANY KRISTEN VINTON 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	1041C0700X	Clinical Social Worker	14680	KS

General Provider Information

NPI Number	:	1144152372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY KRISTEN VINTON LMSW

Provider Business Mailing Address
First Line	:	10329 E COUNTRYSIDE CIR
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67207-5700
Country	:	US
Telephone Number	:	316-619-0640
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 N BROADWAY AVE STE 203
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67214-1145
Country	:	US
Telephone Number	:	316-874-6397
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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