Provider Demographics
NPI:1942619135
Name:BADKE, CAITLYN CHRISTINE (LMSW)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:CHRISTINE
Last Name:BADKE
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 1:32 PONY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67232-9213
Mailing Address - Country:US
Mailing Address - Phone:316-737-2455
Mailing Address - Fax:
Practice Address - Street 1:32 PONY MEADOWS DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67232-9213
Practice Address - Country:US
Practice Address - Phone:316-737-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9252104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker