Provider Demographics
NPI:1457376949
Name:SADOWSKI, DIANE M (LSCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:SADOWSKI
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 1:1321 S MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3635
Mailing Address - Country:US
Mailing Address - Phone:785-242-6525
Mailing Address - Fax:
Practice Address - Street 1:111 W 2ND ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-2212
Practice Address - Country:US
Practice Address - Phone:785-242-8970
Practice Address - Fax:785-242-6770
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCAC 314101YA0400X
KSLSCSW 13721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS071064OtherMEDICARE
KS200428370AMedicaid