Saralyn A. Ativie, MSW, LMSW

Individual provider Active NPI Clinical Social Worker · Fort Leavenworth, KS

NPI 1508960055 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508960055
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801071684 (MI)
Practice address
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Phone
(913) 684-6769
Fax
(913) 684-6766
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801071684 MI Yes

Addresses

Primary practice location

550 Pope Ave
Fort Leavenworth, KS 66027-2332

Mailing address

2912 S.14TH Street
Leavenworth, KS 66048
Phone (913) 684-6769

Other providers in Fort Leavenworth, KS

All providers in Fort Leavenworth, KS · Clinical Social Worker in Kansas

Sources for this page

Verify at the official NPI Registry.