Provider Demographics
NPI:1598415861
Name:AMEND, ANDREW ALLEN (LMSW-T)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:ALLEN
Last Name:AMEND
Suffix:
Gender:M
Credentials:LMSW-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11841 W ONEIL ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-5173
Mailing Address - Country:US
Mailing Address - Phone:316-305-2900
Mailing Address - Fax:
Practice Address - Street 1:6700 W CENTRAL AVE STE 106
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-6302
Practice Address - Country:US
Practice Address - Phone:316-945-5200
Practice Address - Fax:316-945-5549
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12506-T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker