Provider Demographics
NPI:1699836650
Name:THIELE, DACIA CHRISTINE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:DACIA
Middle Name:CHRISTINE
Last Name:THIELE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 W. LAUREL STREET
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301
Mailing Address - Country:US
Mailing Address - Phone:620-205-0164
Mailing Address - Fax:
Practice Address - Street 1:200 ARCO SUITE 501
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301
Practice Address - Country:US
Practice Address - Phone:620-332-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS69991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical