Provider Demographics
NPI:1114023330
Name:ANSTAETT, SHIRLEY J (MSW, LSCSW)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:J
Last Name:ANSTAETT
Suffix:
Gender:F
Credentials:MSW, LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 SW WANAMAKER DR
Mailing Address - Street 2:STE D
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-5321
Mailing Address - Country:US
Mailing Address - Phone:785-266-1577
Mailing Address - Fax:
Practice Address - Street 1:2945 SW WANAMAKER DR
Practice Address - Street 2:STE D
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5321
Practice Address - Country:US
Practice Address - Phone:785-266-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS160544OtherBLUE CROSS BLUE SHIELD #
KS200297050AOtherKS. MEDICAL ASSIST. PROGR
KS200297050AOtherKS. MEDICAL ASSIST. PROGR