Renee E Cristiano, LSCSW

Individual provider Active NPI Clinical Social Worker · Wichita, KS

NPI 1295748044 · NPPES record last updated May 2, 2012

Key facts

NPI
1295748044
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LSCSW480 (KS)
Practice address
815 N Waco Ave
Ste 32
Wichita, KS 67203-3927
Phone
(316) 945-9008
Fax
(316) 462-0514
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LSCSW480KSMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSCSW480 KS Yes

Addresses

Primary practice location

815 N Waco Ave
Ste 32
Wichita, KS 67203-3927

Mailing address

815 N Waco Ave
Ste 32
Wichita, KS 67203-3927
Phone (316) 945-9008

Other identifiers

IdentifierTypeStateIssuer
011057OtherKSBCBS

Other providers in Wichita, KS

All providers in Wichita, KS · Clinical Social Worker in Kansas

Sources for this page

Verify at the official NPI Registry.