Individual
MRS. JEAN MASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW, LCAC
Contact information
Practice address
1616 S 125TH ST E, WICHITA, KS 67207-6508
(316) 617-4052
Mailing address
1616 S 125TH ST E, WICHITA, KS 67207-6508
(316) 617-4052
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
96
KS
104100000X
Social Worker
Primary
5693
KS
1041C0700X
Clinical Social Worker
Primary
3960
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201301
BLUE CROSS
KS
01
—
8870
PREFERRED HEALTH SYSTEMS
KS
Enumeration date
05/22/2006
Last updated
04/18/2026
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