Provider Demographics
NPI:1366910838
Name:ZWEYGARDT, TARYN JEWELL (LMSW)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:JEWELL
Last Name:ZWEYGARDT
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:PO BOX 46
Mailing Address - Street 2:
Mailing Address - City:BENTLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67016-0046
Mailing Address - Country:US
Mailing Address - Phone:316-641-2216
Mailing Address - Fax:
Practice Address - Street 1:315 N HILLSIDE ST STE E
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4915
Practice Address - Country:US
Practice Address - Phone:316-272-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
KS9903104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker