| Angie Lynn, Lscsw, Llc | |
|
123 N Tyler Rd Wichita KS 67212-3713 | |
| (316) 461-1686 | |
| Not Available |
| Full Name | Angie Lynn, Lscsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 123 N Tyler Rd, Wichita, Kansas |
| Authorized Official Name and Position | Angie Lynn (OWNER/CLINICIAN) |
| Authorized Official Contact | 3164611686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angie Lynn, Lscsw, Llc 123 N Tyler Rd Wichita KS 67212-3713 Ph: () - | Angie Lynn, Lscsw, Llc 123 N Tyler Rd Wichita KS 67212-3713 Ph: (316) 461-1686 |
| NPI Number | 1487915245 |
|---|---|
| Provider Enumeration Date | 06/07/2012 |
| Last Update Date | 06/07/2012 |
| Medicare PECOS PAC ID | 9537317110 |
|---|---|
| Medicare Enrollment ID | O20120925000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487915245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3578 (Kansas) | Primary |
| Provider Name | Angie M Lynn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851319263 PECOS PAC ID: 3072548783 Enrollment ID: I20050930000797 |
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