Provider Demographics
NPI:1124493390
Name:HENSLEY, VICTORIA A (LMSW)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:A
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:FRONTENAC
Mailing Address - State:KS
Mailing Address - Zip Code:66763-2120
Mailing Address - Country:US
Mailing Address - Phone:620-249-4901
Mailing Address - Fax:
Practice Address - Street 1:911 E CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6601
Practice Address - Country:US
Practice Address - Phone:620-235-7143
Practice Address - Fax:620-235-7148
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9870104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker