Provider Demographics
NPI:1720160930
Name:VONDEMKAMP, ELIZABETH M (LSCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:VONDEMKAMP
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 1:4707 COLLEGE BLVD
Mailing Address - Street 2:213
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1933
Mailing Address - Country:US
Mailing Address - Phone:913-663-3000
Mailing Address - Fax:913-663-1115
Practice Address - Street 1:4707 COLLEGE BLVD
Practice Address - Street 2:213
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1933
Practice Address - Country:US
Practice Address - Phone:913-663-3000
Practice Address - Fax:913-663-1115
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2425104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker