Provider Demographics
NPI:1649381567
Name:HANDER, KIM KAY (LCMFT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:KAY
Last Name:HANDER
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 SW CLAY ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3078
Mailing Address - Country:US
Mailing Address - Phone:785-234-5663
Mailing Address - Fax:785-232-6811
Practice Address - Street 1:5655 SW 34TH PL
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4581
Practice Address - Country:US
Practice Address - Phone:785-271-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCMFT 245106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist