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Other names
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Organization subpart
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Provider details

NPI number
Authorized official
JANEL SANFORD LMSW, LMAC (CEO/ CLINICIAN)
(316) 759-9136
Entity
Organization

Contact information

Practice address
300 W DOUGLAS AVE STE 205, WICHITA, KS 67202-2904
(316) 759-9136
(316) 500-7862
Mailing address
300 W DOUGLAS AVE STE 205, WICHITA, KS 67202-2904
(316) 759-9136
(316) 500-7862

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13564020
CAQH
05
201125860A
KS
05
3004627850001
KS
Enumeration date
07/12/2018
Last updated
06/09/2020
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