Provider Demographics
NPI:1336920677
Name:PHILLIPS, ABBI LYNNE (LMSW-T)
Entity Type:Individual
Prefix:
First Name:ABBI
Middle Name:LYNNE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LMSW-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6680 SE 70TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:KS
Mailing Address - Zip Code:66770-4208
Mailing Address - Country:US
Mailing Address - Phone:620-687-5236
Mailing Address - Fax:
Practice Address - Street 1:3101 N MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-2543
Practice Address - Country:US
Practice Address - Phone:620-687-5236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker