Provider Demographics
NPI:1760773048
Name:ORMISTON, JOHN W (LSCSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:ORMISTON
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N LANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-6608
Mailing Address - Country:US
Mailing Address - Phone:316-272-8300
Mailing Address - Fax:
Practice Address - Street 1:8100 E 22ND ST N BLDG 2300-3
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2306
Practice Address - Country:US
Practice Address - Phone:316-660-7525
Practice Address - Fax:316-660-7510
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7902104100000X
KS45281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker