Provider Demographics
NPI:1073160396
Name:ENGELKE, CARMEN
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:ENGELKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-0547
Mailing Address - Country:US
Mailing Address - Phone:785-543-5211
Mailing Address - Fax:785-543-5274
Practice Address - Street 1:1719 HIGHWAY 183
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-2549
Practice Address - Country:US
Practice Address - Phone:785-543-5211
Practice Address - Fax:785-543-5274
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS113161041C0700X
KS057401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical