Provider Demographics
NPI:1740353101
Name:JAN C HENDRIX LCPC LSCSW PA
Entity type:Organization
Organization Name:JAN C HENDRIX LCPC LSCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORK
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-271-1662
Mailing Address - Street 1:2300 SW 29TH STREET SUITE 222
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611
Mailing Address - Country:US
Mailing Address - Phone:785-271-1662
Mailing Address - Fax:785-267-3439
Practice Address - Street 1:2300 SW 29TH STREET SUITE 222
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611
Practice Address - Country:US
Practice Address - Phone:785-271-1662
Practice Address - Fax:785-267-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 23561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty