| Heather L. Holcomb, Lscsw, Llc | |
|
8100 E 22nd St N Building 100 Suite 2 Wichita KS 67226-2388 | |
| (316) 300-5787 | |
| (316) 337-5481 |
| Full Name | Heather L. Holcomb, Lscsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8100 E 22nd St N, Wichita, Kansas |
| Authorized Official Name and Position | Heather L Holcomb (OWNER) |
| Authorized Official Contact | 3163005787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heather L. Holcomb, Lscsw, Llc 8100 E 22nd St N Building 100 Suite 2 Wichita KS 67226-2388 Ph: (316) 300-5787 | Heather L. Holcomb, Lscsw, Llc 8100 E 22nd St N Building 100 Suite 2 Wichita KS 67226-2388 Ph: (316) 300-5787 |
| NPI Number | 1326499237 |
|---|---|
| Provider Enumeration Date | 06/22/2016 |
| Last Update Date | 06/28/2016 |
| Medicare PECOS PAC ID | 6002197910 |
|---|---|
| Medicare Enrollment ID | O20170109002639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326499237 | NPI | - | NPPES |
| 1205945474 | Other | KS | INDIVIDUAL NPI NUMBER |
| 070952 | Other | KS | MEDICARE PTAN # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2259 (Kansas) | Primary |
| Provider Name | Heather Holcomb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205945474 PECOS PAC ID: 9133228646 Enrollment ID: I20070625000485 |
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