Provider Demographics
NPI:1831180033
Name:COUNTY OF SEDGWICK
Entity type:Organization
Organization Name:COUNTY OF SEDGWICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMMANY
Authorized Official - Suffix:
Authorized Official - Credentials:LMLP
Authorized Official - Phone:316-660-7665
Mailing Address - Street 1:271 W 3RD ST N STE 600
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-1223
Mailing Address - Country:US
Mailing Address - Phone:316-660-7600
Mailing Address - Fax:316-941-5075
Practice Address - Street 1:635 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3602
Practice Address - Country:US
Practice Address - Phone:316-660-7600
Practice Address - Fax:316-660-7510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100056230CMedicaid
KS100237150FMedicaid
KS006904OtherBCBS GROUP #
KS100229160AMedicaid
KS116044OtherBLUE CROSS OSAF PROV #
KS324716OtherVALUE OPTIONS PROV #
KS100056230AMedicaid
KS100080500BMedicaid
KS006904Medicare ID - Type UnspecifiedMEDICARE GROUP #
KS100056230AMedicaid