Provider Demographics
NPI:1710289582
Name:SARAH M. THOME, LSCSW, LLC
Entity Type:Organization
Organization Name:SARAH M. THOME, LSCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SPECIALIST CLINICAL SOCIAL
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOME
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW, LLC
Authorized Official - Phone:316-869-2220
Mailing Address - Street 1:123 N. TYLER ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-3726
Mailing Address - Country:US
Mailing Address - Phone:316-869-2220
Mailing Address - Fax:316-869-2221
Practice Address - Street 1:123 N. TYLER ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-3726
Practice Address - Country:US
Practice Address - Phone:316-869-2220
Practice Address - Fax:316-869-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS39181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty