Provider Demographics
NPI:1093729337
Name:CAROLAN-STEGMAN, MARTHA DIANE (LSCSW)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:DIANE
Last Name:CAROLAN-STEGMAN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:CAROLAN-STEGMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, LISW
Mailing Address - Street 1:9520 W 148TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-8203
Mailing Address - Country:US
Mailing Address - Phone:913-353-4302
Mailing Address - Fax:913-225-9026
Practice Address - Street 1:4601 COLLEGE BLVD., SUITE 275
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-353-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI39511041C0700X
KS8131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical