Provider Demographics
NPI:1740588953
Name:SALISBURY, STEPHANIE J (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:J
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 562
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67029-0562
Mailing Address - Country:US
Mailing Address - Phone:785-580-8698
Mailing Address - Fax:
Practice Address - Street 1:400 E WALNUT ST STE 6
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:KS
Practice Address - Zip Code:67029-6495
Practice Address - Country:US
Practice Address - Phone:785-580-8698
Practice Address - Fax:785-706-5575
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00805101YA0400X
KST-LMSW 7998104100000X
KS45741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker