Organization
BROOKSIDE MENTAL HEALTH & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ANN DUGAN LSCSW,CFT (SOCIAL WORKER)
(785) 272-8808
Entity
Organization
Contact information
Practice address
3601 SW 29TH ST, SUITE 217, TOPEKA, KS 66614-2078
(785) 272-8808
(785) 272-0814
Mailing address
3601 SW 29TH ST, SUITE 217, TOPEKA, KS 66614-2078
(785) 272-8808
(785) 272-0814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1176
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41081
GROUP- BC/BS
KS
01
—
41083
BILLING PROVIDER #
KS
Enumeration date
02/24/2006
Last updated
08/22/2020
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