Provider Demographics
NPI:1265682421
Name:CARR, LEE ANN (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:LEE ANN
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MS
Other - First Name:LEE ANN
Other - Middle Name:
Other - Last Name:BALKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:9415 EAST HARRY
Mailing Address - Street 2:BUILDING 800
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207
Mailing Address - Country:US
Mailing Address - Phone:316-686-6303
Mailing Address - Fax:316-686-6767
Practice Address - Street 1:9415 EAST HARRY
Practice Address - Street 2:BUILDING 800
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207
Practice Address - Country:US
Practice Address - Phone:316-686-6303
Practice Address - Fax:316-686-6764
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical