Provider Demographics
NPI:1013085653
Name:SUMMERS, JOHN STEVEN (MSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STEVEN
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 SW QUIVIRA DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3537
Mailing Address - Country:US
Mailing Address - Phone:785-979-4715
Mailing Address - Fax:785-273-4382
Practice Address - Street 1:1828 SW QUIVIRA DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3537
Practice Address - Country:US
Practice Address - Phone:785-979-4715
Practice Address - Fax:785-273-4382
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS06451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000010148OtherBLUE CROSS BLUE SHIELD KS