Provider Demographics
NPI:1962601013
Name:HALDEMAN-SMITH, SARAH A (LSCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:HALDEMAN-SMITH
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 1:1528 W HANEY SOUTH CT
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-7910
Mailing Address - Country:US
Mailing Address - Phone:316-215-9359
Mailing Address - Fax:855-871-5714
Practice Address - Street 1:2626 S ROCK RD STE 110
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67210-1857
Practice Address - Country:US
Practice Address - Phone:316-215-9359
Practice Address - Fax:855-871-5714
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS056221041C0700X
KS6337104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200437660BMedicaid
KS30004522510002Medicaid