Provider Demographics
NPI:1366853657
Name:SWEENEY KNIEP, DAWN (LCMFT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SWEENEY KNIEP
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8068
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0068
Mailing Address - Country:US
Mailing Address - Phone:316-641-3378
Mailing Address - Fax:855-523-6066
Practice Address - Street 1:2920 E 33RD ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67219-4906
Practice Address - Country:US
Practice Address - Phone:316-351-8684
Practice Address - Fax:855-523-6066
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2856106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004555730001Medicaid