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NPI Code Detail

MEDICARE: JOSEPHINE OLDHAM LSCSW

MEDICARE: JOSEPHINE OLDHAM 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
11041C0700XClinical Social Worker4308KS

General Provider Information

NPI Number : 1194137976
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPHINE OLDHAM LSCSW
Provider Business Mailing Address
First Line : 100 S MAIN ST STE 505
Second Line :
City : WICHITA
State : KS
Zip : 67202-3738
Country : US
Telephone Number : 316-685-2221
Fax Number :
Provider Business Practice Location Address
First Line : 100 S MAIN ST STE 505
Second Line :
City : WICHITA
State : KS
Zip : 67202-3738
Country : US
Telephone Number : 316-685-2221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2014
Last Update Date : 07/17/2023

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Directions to “ JOSEPHINE OLDHAM LSCSW” Practice Location

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