Provider Demographics
NPI:1689235400
Name:ANDERSEN, ARYN NICOLE (LSCSW)
Entity Type:Individual
Prefix:
First Name:ARYN
Middle Name:NICOLE
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:ARYN
Other - Middle Name:
Other - Last Name:SCHOWENGERDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66505-0747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:406 N 3RD ST STE 3
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66508-1497
Practice Address - Country:US
Practice Address - Phone:785-562-3907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11339104100000X
KS057221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker