Provider Demographics
NPI:1982894457
Name:HOUSEMAN, ELWOOD D (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ELWOOD
Middle Name:D
Last Name:HOUSEMAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6361 134TH ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY FALLS
Mailing Address - State:KS
Mailing Address - Zip Code:66088-5188
Mailing Address - Country:US
Mailing Address - Phone:785-945-4030
Mailing Address - Fax:
Practice Address - Street 1:3649 SW BURLINGAME RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2051
Practice Address - Country:US
Practice Address - Phone:785-266-6751
Practice Address - Fax:785-266-4533
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSMFT 708106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSMFT 708OtherBEHAVIORAL SCIENCES REGUL