Provider Demographics
NPI:1417159070
Name:JIM L. WOODWARD, MSW, PA
Entity Type:Organization
Organization Name:JIM L. WOODWARD, MSW, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-273-6200
Mailing Address - Street 1:5040 SW 28TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2302
Mailing Address - Country:US
Mailing Address - Phone:785-273-6200
Mailing Address - Fax:785-273-6249
Practice Address - Street 1:5040 SW 28TH ST
Practice Address - Street 2:STE B
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2302
Practice Address - Country:US
Practice Address - Phone:785-273-6200
Practice Address - Fax:785-273-6249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC1471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSBCBSOther180504