Provider Demographics
NPI:1093809436
Name:VEESART, RYAN (LSCSW)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:VEESART
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:LAKIN
Mailing Address - State:KS
Mailing Address - Zip Code:67860-0166
Mailing Address - Country:US
Mailing Address - Phone:620-355-8456
Mailing Address - Fax:
Practice Address - Street 1:1851 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:LAKIN
Practice Address - State:KS
Practice Address - Zip Code:67860-0166
Practice Address - Country:US
Practice Address - Phone:620-355-8456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS40721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical