Individual
KENNETH MCNUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSCSW
Contact information
Practice address
1421 E 2ND ST N, WICHITA, KS 67214-4119
(316) 239-8892
Mailing address
1421 E 2ND ST N, WICHITA, KS 67214-4119
(316) 239-8892
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4587
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200624000A
—
KS
Enumeration date
10/08/2009
Last updated
11/06/2021
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