Provider Demographics
NPI:1659631620
Name:SUTTON, KAREN ELAINE (LMSW, LAC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ELAINE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LMSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 N LIGHTNER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-2747
Mailing Address - Country:US
Mailing Address - Phone:316-295-4186
Mailing Address - Fax:
Practice Address - Street 1:1319 W MAY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-3505
Practice Address - Country:US
Practice Address - Phone:316-262-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS83481041C0700X
KS944101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)