Provider Demographics
NPI:1306025317
Name:NEWMAN, MARY KATHLEEN (LMSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHLEEN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:GABBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4601 E DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1011
Mailing Address - Country:US
Mailing Address - Phone:785-608-8429
Mailing Address - Fax:844-811-6367
Practice Address - Street 1:4601 E DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1011
Practice Address - Country:US
Practice Address - Phone:785-608-8429
Practice Address - Fax:844-811-6367
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5376104100000X
KS4125104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker