Provider Demographics
NPI:1770844235
Name:BOGGESS, BRITTIN L (LMSW)
Entity Type:Individual
Prefix:
First Name:BRITTIN
Middle Name:L
Last Name:BOGGESS
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 1:13710 W TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-9102
Mailing Address - Country:US
Mailing Address - Phone:316-312-4346
Mailing Address - Fax:
Practice Address - Street 1:13710 W TEXAS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67235-9102
Practice Address - Country:US
Practice Address - Phone:316-312-4346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8033104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker