Provider Demographics
NPI:1801551890
Name:BOELK, KARA ESTHER (LMSW)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:ESTHER
Last Name:BOELK
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 1:205 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67117-8064
Mailing Address - Country:US
Mailing Address - Phone:620-960-2319
Mailing Address - Fax:
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-685-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10889104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker