Provider Demographics
NPI:1205201043
Name:MENKVELD, KRISTIN
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MENKVELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:SUNLEY, INGEBRETSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3430 SE HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605-2436
Mailing Address - Country:US
Mailing Address - Phone:303-968-7919
Mailing Address - Fax:
Practice Address - Street 1:305 SE 17TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66607-1266
Practice Address - Country:US
Practice Address - Phone:303-968-7919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 42811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical