Provider Demographics
NPI:1306842976
Name:PAVLICK, SARA A (LMSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:PAVLICK
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 1:7701 E KELLOGG DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-1706
Mailing Address - Country:US
Mailing Address - Phone:316-660-9600
Mailing Address - Fax:316-660-9660
Practice Address - Street 1:7701 E KELLOGG DR
Practice Address - Street 2:SUITE 300
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-1706
Practice Address - Country:US
Practice Address - Phone:316-660-9600
Practice Address - Fax:316-660-9660
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker