Provider Demographics
NPI:1780616367
Name:YANT-WARNKE, THERESA ANN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ANN
Last Name:YANT-WARNKE
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 1:121 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:NE
Mailing Address - Zip Code:68865-1727
Mailing Address - Country:US
Mailing Address - Phone:308-382-3660
Mailing Address - Fax:308-389-5136
Practice Address - Street 1:121 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:PHILLIPS
Practice Address - State:NE
Practice Address - Zip Code:68865-1727
Practice Address - Country:US
Practice Address - Phone:308-382-3660
Practice Address - Fax:308-389-5136
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW25511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical