Provider Demographics
NPI:1740955178
Name:SIDESINGER, MARIAH (LMSW)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:SIDESINGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 SW BURNETT RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3421
Mailing Address - Country:US
Mailing Address - Phone:785-817-6067
Mailing Address - Fax:
Practice Address - Street 1:10437 SW 53RD ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66610-9130
Practice Address - Country:US
Practice Address - Phone:785-817-6067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12281104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker