MEDICARE: JIM L. WOODWARD LSCSW

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	147	KS

General Provider Information

NPI Number	:	1144280264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIM L. WOODWARD LSCSW

Provider Business Mailing Address
First Line	:	5040 SW 28TH ST
Second Line	:	SUITE B
City	:	TOPEKA
State	:	KS
Zip	:	66614-2302
Country	:	US
Telephone Number	:	785-273-6200
Fax Number	:	785-273-6249

Provider Business Practice Location Address
First Line	:	5040 SW 28TH ST
Second Line	:	SUITE B
City	:	TOPEKA
State	:	KS
Zip	:	66614-2302
Country	:	US
Telephone Number	:	785-273-6200
Fax Number	:	785-273-6249

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	11/07/2024

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