Provider Demographics
NPI:1568669455
Name:DENNIS, INGRID VERONICA (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:VERONICA
Last Name:DENNIS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 N MILSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-5429
Mailing Address - Country:US
Mailing Address - Phone:316-721-7880
Mailing Address - Fax:
Practice Address - Street 1:1148 S HILLSIDE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-4005
Practice Address - Country:US
Practice Address - Phone:316-687-0006
Practice Address - Fax:316-687-0328
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2056104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker