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NPI Code Detail

MEDICARE: J. OLDHAM, LSCSW, P.A.

MEDICARE: J. OLDHAM, LSCSW, P.A.
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 : 1306363163
Entity Type Code : Organization
Provider Name (Legal Business Name) : J. OLDHAM, LSCSW, P.A.
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 : 316-688-8390
Fax Number : 316-688-8390
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 : 316-688-8390
Fax Number : 316-688-8390
Authorized Official
Title or Position : OWNER
Name : MS. JOSEPHINE ELIZABETH OLDHAM
Credential : LSCSW
Telephone Number : 316-688-8390
Provider Enumeration Date : 08/23/2017
Last Update Date : 07/17/2023

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