Stephanie E Putnam, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05265 Issued in KS

Practice address

1601 W 16TH St
Wellington, KS 67152-8125

Phone

(620) 326-7448

Fax

(620) 326-6662

NPI assigned

May 31, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sumner Mental Health Center

  • Mental Health Counselor
  • Wellington, KS
  • NPI 1093735896
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1033567045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "WELLINGTON",
            "state": "KS",
            "postal_code": "671520607",
            "telephone_number": "620-326-7448",
            "fax_number": "620-326-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W 16TH ST",
            "city": "WELLINGTON",
            "state": "KS",
            "postal_code": "671528125",
            "telephone_number": "620-326-7448",
            "fax_number": "620-326-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "STEPHANIE",
        "middle_name": "E",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9958",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "05265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201135820A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Partridge, COTA
• Cristin Peetoom, RPH
• Heather M Pelkey, LMSW
• Jennie L Pinion
• Sarah Marie Pond, APRN
• Radmila Radovanov, M.D.
• Diana Rhiley, LCMFT
• Alice Ricke
• Joshua Clayton Rikard
• Kathy Risley, CADACII

• Clinical Social Worker in Wellington, KS
• Providers in Wellington, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.