MEDICARE: MR. LARRY D 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	0303	KS

General Provider Information

NPI Number	:	1841418266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LARRY D WOODWARD LSCSW

Provider Business Mailing Address
First Line	:	1701 SW MEDFORD AVE
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66604-3147
Country	:	US
Telephone Number	:	785-233-0666
Fax Number	:	785-233-8065

Provider Business Practice Location Address
First Line	:	1701 SW MEDFORD AVE
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66604-3147
Country	:	US
Telephone Number	:	785-233-0666
Fax Number	:	785-233-8065

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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