Tina Haefke

Individual provider Active NPI Clinical Social Worker · Holton, KS

NPI 1841474558 · NPPES record last updated Dec 18, 2007

Key facts

NPI
1841474558
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LMSW 3095 (KS)
Practice address
14839 254TH Rd
Holton, KS 66436-8764
Phone
(785) 364-5060
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
Yes

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 participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LMSW 3095KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Allies Therapeutic Services Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LMSW 3095 KS Yes

Addresses

Primary practice location

14839 254TH Rd
Holton, KS 66436-8764

Mailing address

14839 254TH Rd
Holton, KS 66436-8764
Phone (785) 364-5060

Other providers in Holton, KS

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

Sources for this page

Verify at the official NPI Registry.