Organization
KASEY SHEPHERD LSCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA M WILLIAMS (CREDENTIALING SPECIALIST)
(316) 516-2339
Entity
Organization
Contact information
Practice address
200 N BROADWAY AVE STE 500, WICHITA, KS 67202-2322
(316) 425-7774
(316) 425-7779
Mailing address
200 N BROADWAY AVE STE 500, WICHITA, KS 67202-2322
(316) 425-7774
(316) 425-7779
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201259410A
—
KS
Enumeration date
07/06/2020
Last updated
06/24/2024
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