Provider Demographics
NPI:1538059647
Name:VANATTA, KATLYN (LMSW)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:VANATTA
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 1:1106 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:KS
Mailing Address - Zip Code:66748-1934
Mailing Address - Country:US
Mailing Address - Phone:620-473-2241
Mailing Address - Fax:
Practice Address - Street 1:304 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-2327
Practice Address - Country:US
Practice Address - Phone:620-365-5717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14265-T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker