Provider Demographics
NPI:1215404611
Name:TOON, MARY K (LMSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:TOON
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 1:200 N BROADWAY AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-2301
Mailing Address - Country:US
Mailing Address - Phone:316-425-7774
Mailing Address - Fax:316-941-5075
Practice Address - Street 1:200 N BROADWAY AVE FL 5
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2301
Practice Address - Country:US
Practice Address - Phone:316-425-7774
Practice Address - Fax:316-941-5075
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11101104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker