Provider Demographics
NPI:1841418266
Name:WOODWARD, LARRY D (LSCSW)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:D
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 SW MEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3147
Mailing Address - Country:US
Mailing Address - Phone:785-233-0666
Mailing Address - Fax:785-233-8065
Practice Address - Street 1:1701 SW MEDFORD AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3147
Practice Address - Country:US
Practice Address - Phone:785-233-0666
Practice Address - Fax:785-233-8065
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical