Provider Demographics
NPI:1265432462
Name:MCGINNIS, TAMMY LEA (MSW, LSCSW)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LEA
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:MSW, LSCSW
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:LEA
Other - Last Name:HOWSER-MCGINNIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LSCSW
Mailing Address - Street 1:4300 SE OAKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1638
Mailing Address - Country:US
Mailing Address - Phone:785-249-4380
Mailing Address - Fax:
Practice Address - Street 1:3600 SW BURLINGAME RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2053
Practice Address - Country:US
Practice Address - Phone:785-246-6360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 13831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R75983Medicare UPIN
KS069525Medicare ID - Type Unspecified