Provider Demographics
NPI:1114950334
Name:HABERICHTER, ANGIE (LMSW)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:HABERICHTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:560 N. EXPOSITION
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203
Mailing Address - Country:US
Mailing Address - Phone:316-264-8317
Mailing Address - Fax:316-264-0347
Practice Address - Street 1:560 N. EXPOSITION
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203
Practice Address - Country:US
Practice Address - Phone:316-264-8317
Practice Address - Fax:316-264-0347
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS41351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical