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NPI Code Detail

MEDICARE: RHONDA L. NUTTER LSCSW LLC

MEDICARE: RHONDA L. NUTTER LSCSW LLC
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 Worker

General Provider Information

NPI Number : 1871151860
Entity Type Code : Organization
Provider Name (Legal Business Name) : RHONDA L. NUTTER LSCSW LLC
Provider Business Mailing Address
First Line : 1102 S MINNEAPOLIS AVE
Second Line :
City : WICHITA
State : KS
Zip : 67211-2728
Country : US
Telephone Number : 316-558-6468
Fax Number :
Provider Business Practice Location Address
First Line : 3500 N ROCK RD BLDG 100
Second Line :
City : WICHITA
State : KS
Zip : 67226-1328
Country : US
Telephone Number : 316-285-0633
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : MS. RHONDA LEE NUTTER
Credential : LSCSW
Telephone Number : 316-285-0633
Provider Enumeration Date : 06/04/2019
Last Update Date : 01/27/2020

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