Provider / Organization | NPI | Date Certified |
---|---|---|
MICHELLE DAWN STAFFORD | 1477849925 | 2024-07-05 |
Michelle Dawn Stafford is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1477849925. Registration indicates Michelle Dawn Stafford is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Social Worker (Behavioral Health & Social Service Providers, Social Worker) (Social Worker: Clinical, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker Clinical, Behavioral Health & Social Service Providers) (Social Worker, )
Entity Type | Individual |
Provider Name | Michelle Dawn Stafford LMSW |
Practice Office Address | 1601 W 16TH ST WELLINGTON, KS US |
Practice Office Telephone | 6203267448 |
Practice Office Fax | 6203266662 |
Mailing Address | 1601 W 16TH ST P O BOX 607 WELLINGTON, KS 671528125 US |
Business Telephone | 6203267448 |
Business Fax | 6203266662 |
Code | Practice | License No State |
---|---|---|
1041C0700X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Social Worker Behavioral Health & Social Service Providers Social Worker Social Worker: Clinical Behavioral Health/Substance Abuse/Psychiatry Social Worker Clinical Behavioral Health & Social Service Providers Social Worker | 06458
KS |
100229020A | MEDICAID | KS |