Provider Demographics
NPI:1063664506
Name:SCHWENK, CARMEN F (LSCSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:F
Last Name:SCHWENK
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 POYNTZ AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-4145
Mailing Address - Country:US
Mailing Address - Phone:785-776-4105
Mailing Address - Fax:785-537-2299
Practice Address - Street 1:1408 POYNTZ AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4145
Practice Address - Country:US
Practice Address - Phone:785-776-4105
Practice Address - Fax:785-537-2299
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS21551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical