Kesha Elaine Grace

Individual provider Active NPI Social Worker · Winfield, KS

NPI 1992247381 · NPPES record last updated Dec 20, 2023

Key facts

NPI
1992247381
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
13289 (KS)
Practice address
118 W 9TH Ave
Winfield, KS 67156-2852
Phone
(620) 402-6641
Fax
(620) 221-3350
NPI assigned
Nov 16, 2016
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)
No

State licenses

LicenseStateTypeSpecialty
8983OKMDSocial Worker
13289KSMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8983 OK
Case Manager/Care Coordinator 171M00000X
Social Worker 104100000X 13289 KS Yes

Addresses

Primary practice location

118 W 9TH Ave
Winfield, KS 67156-2852

Mailing address

118 W 9TH Ave
Winfield, KS 67156-2852
Phone (620) 402-6641

Other providers in Winfield, KS

All providers in Winfield, KS · Social Worker in Kansas

Sources for this page

Verify at the official NPI Registry.