MEDICARE: ALYSSA VONAGHER 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	13659	KS

General Provider Information

NPI Number	:	1619710803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA VONAGHER LMSW

Provider Business Mailing Address
First Line	:	4013 N RIDGE RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-8857
Country	:	US
Telephone Number	:	316-945-5200
Fax Number	:	316-945-5549

Provider Business Practice Location Address
First Line	:	4013 N RIDGE RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-8857
Country	:	US
Telephone Number	:	316-945-5200
Fax Number	:	316-945-5549

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

Provider Enumeration Date	:	06/14/2024
Last Update Date	:	06/04/2026

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Directions to “ ALYSSA VONAGHER LMSW” Practice Location

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