Provider Demographics
NPI:1134173149
Name:WHALEY, MEREDITH A (LSCSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:WHALEY
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 1:4505 E 47TH ST S
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67210-1651
Mailing Address - Country:US
Mailing Address - Phone:316-529-9290
Mailing Address - Fax:316-529-9351
Practice Address - Street 1:4505 E 47TH ST S
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67210-1651
Practice Address - Country:US
Practice Address - Phone:316-529-9290
Practice Address - Fax:316-529-9351
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5088104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker