Provider Demographics
NPI:1154116432
Name:DECHARD, KATELYN ALICIA (LMSW)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ALICIA
Last Name:DECHARD
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:ALICIA
Other - Last Name:SMART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:213 E BATES ST
Mailing Address - Street 2:
Mailing Address - City:DREXEL
Mailing Address - State:MO
Mailing Address - Zip Code:64742-9106
Mailing Address - Country:US
Mailing Address - Phone:716-640-3197
Mailing Address - Fax:
Practice Address - Street 1:100 LAKEMARY DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1855
Practice Address - Country:US
Practice Address - Phone:913-557-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13816104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker