Provider Demographics
NPI:1073557765
Name:FELTON, LIANE (LSCSW)
Entity type:Individual
Prefix:
First Name:LIANE
Middle Name:
Last Name:FELTON
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:LIANE
Other - Middle Name:
Other - Last Name:REUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 N. BROADWAY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202
Mailing Address - Country:US
Mailing Address - Phone:316-858-1200
Mailing Address - Fax:316-858-1204
Practice Address - Street 1:200 N BROADWAY ST
Practice Address - Street 2:SUITE 600
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2324
Practice Address - Country:US
Practice Address - Phone:316-858-1200
Practice Address - Fax:316-858-1204
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS19921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical