Provider Demographics
NPI:1699703769
Name:SUTTON, MELBA JOYCE (LSCSW)
Entity type:Individual
Prefix:MS
First Name:MELBA
Middle Name:JOYCE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 SW HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3950
Mailing Address - Country:US
Mailing Address - Phone:785-845-2991
Mailing Address - Fax:
Practice Address - Street 1:1123 SW HIGH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3950
Practice Address - Country:US
Practice Address - Phone:785-845-2991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS36211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical