Provider Demographics
NPI:1083777221
Name:HERNANDEZ, SYLVIA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6014 E IRONHORSE CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-5511
Mailing Address - Country:US
Mailing Address - Phone:316-833-8398
Mailing Address - Fax:
Practice Address - Street 1:22214 D ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-7376
Practice Address - Country:US
Practice Address - Phone:620-221-9664
Practice Address - Fax:620-221-1983
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6307104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker