Provider Demographics
NPI:1922299809
Name:MYERS, KATHLEEN ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:MYERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10222 W CENTRAL AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-4613
Mailing Address - Country:US
Mailing Address - Phone:316-773-9525
Mailing Address - Fax:316-773-2012
Practice Address - Street 1:10222 W CENTRAL AVE STE 202
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4613
Practice Address - Country:US
Practice Address - Phone:316-773-9525
Practice Address - Fax:316-773-2012
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical