Provider Demographics
NPI:1598415861
Name:AMEND, ANDREW (LSCSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:AMEND
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 W MAPLE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3148
Mailing Address - Country:US
Mailing Address - Phone:316-305-2900
Mailing Address - Fax:833-392-1160
Practice Address - Street 1:10100 W MAPLE ST STE 101
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3148
Practice Address - Country:US
Practice Address - Phone:316-416-6400
Practice Address - Fax:833-392-1160
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS067851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004820480002Medicaid