Provider Demographics
NPI:1467170548
Name:CORTEZ, ERIC (LSCSW)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SE 9TH ST APT 811
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66612-1219
Mailing Address - Country:US
Mailing Address - Phone:785-845-4475
Mailing Address - Fax:
Practice Address - Street 1:2001 SW FAIRLAWN RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3654
Practice Address - Country:US
Practice Address - Phone:785-438-4019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS96071041C0700X
KS058901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical