MEDICARE: LARRY L HUEY 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	LSCSW 1212	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	011502	OTHER	KS	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1871599167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY L HUEY LSCSW

Provider Business Mailing Address
First Line	:	5040 SW 28TH ST
Second Line	:	STE F
City	:	TOPEKA
State	:	KS
Zip	:	66614-2302
Country	:	US
Telephone Number	:	785-272-2266
Fax Number	:	785-273-9972

Provider Business Practice Location Address
First Line	:	5040 SW 28TH ST
Second Line	:	STE F
City	:	TOPEKA
State	:	KS
Zip	:	66614-2302
Country	:	US
Telephone Number	:	785-272-2266
Fax Number	:	785-273-9972

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	11/07/2022

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