Provider Demographics
NPI:1922380831
Name:WURTZ, SARAH JK (LMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JK
Last Name:WURTZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 EAST HARRY
Mailing Address - Street 2:BUILDING 800
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207
Mailing Address - Country:US
Mailing Address - Phone:316-686-6303
Mailing Address - Fax:316-686-6764
Practice Address - Street 1:9415 EAST HARRY
Practice Address - Street 2:BUILDING 800
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207
Practice Address - Country:US
Practice Address - Phone:316-686-6303
Practice Address - Fax:316-686-6764
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1110106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist