Provider Demographics
NPI:1982843843
Name:HAENISCH, ROBYN ANN (LSCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ANN
Last Name:HAENISCH
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34700 W HIGHWAY 56
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:KS
Mailing Address - Zip Code:66021-2234
Mailing Address - Country:US
Mailing Address - Phone:913-406-2257
Mailing Address - Fax:913-893-6918
Practice Address - Street 1:34700 W HIGHWAY 56
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:KS
Practice Address - Zip Code:66021-2234
Practice Address - Country:US
Practice Address - Phone:913-406-2257
Practice Address - Fax:913-893-6918
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical