MEDICARE: JESSICA CHARITY SADDLER 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	3988	KS

General Provider Information

NPI Number	:	1982576849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CHARITY SADDLER LSCSW

Provider Business Mailing Address
First Line	:	3206 WILLOW ST
Second Line	:
City	:	HAYS
State	:	KS
Zip	:	67601-1727
Country	:	US
Telephone Number	:	719-289-8743
Fax Number	:	785-734-0447

Provider Business Practice Location Address
First Line	:	302 FLEMING ST STE 5
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6162
Country	:	US
Telephone Number	:	719-289-8743
Fax Number	:	785-734-0447

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

Provider Enumeration Date	:	09/20/2025
Last Update Date	:	09/20/2025

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