Provider Demographics
NPI:1508010877
Name:DRAKE, NANCY SUSAN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:SUSAN
Last Name:DRAKE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 215TH RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:KS
Mailing Address - Zip Code:66087-4056
Mailing Address - Country:US
Mailing Address - Phone:785-850-1196
Mailing Address - Fax:
Practice Address - Street 1:1208 215TH RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:KS
Practice Address - Zip Code:66087-4056
Practice Address - Country:US
Practice Address - Phone:785-850-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical