Alpha Warren Bales, LSCSW

Individual provider Active NPI Clinical Social Worker · Hiawatha, KS

NPI 1588798136 · NPPES record last updated Jan 25, 2012

Key facts

NPI
1588798136
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
4051 (KS)
Practice address
909 S 2ND St
Hiawatha, KS 66434-2774
Phone
(785) 742-7113
Fax
(785) 742-3085
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kanza Mental Health and Guidance Center, Inc. (9 clinicians)

Practice addresses (Care Compare)

909 S 2ND St
Hiawatha, KS 66434-2774
Phone (785) 742-7113

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110504000333 KS Practitioner - Clinical Social Worker 5092990200 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Kanza Mental Health and Guidance Center, Inc. Current
since Mar 26, 2011
Accepting new patients

Locations

909 S 2nd St
Hiawatha, KS 66434
Phone (785) 742-7113

510 Kansas Ave
Holton, KS 66436
Phone 78536421162195

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4051 KS Yes

Addresses

Primary practice location

909 S 2ND St
Hiawatha, KS 66434-2774

Mailing address

1400 SW Clontarf St
Topeka, KS 66611-2420
Phone (785) 267-4740

Other identifiers

IdentifierTypeStateIssuer
100097950AMedicaidKS
200434510AMedicaidKS

Other providers in Hiawatha, KS

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

Sources for this page

Verify at the official NPI Registry.