1235153420 NPI number — MRS. MARGARET RUTH CRANSTON LSCSW

Table of content: MRS. MARGARET RUTH CRANSTON LSCSW (NPI 1235153420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235153420 NPI number — MRS. MARGARET RUTH CRANSTON LSCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRANSTON
Provider First Name:
MARGARET
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LSCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOGER-CRANSTON
Provider Other First Name:
MARGARET
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LSCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1235153420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
807 N WACO AVE
Provider Second Line Business Mailing Address:
STE 22
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67203-3971
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-977-8400
Provider Business Mailing Address Fax Number:
844-308-5804

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
807 N WACO AVE
Provider Second Line Business Practice Location Address:
STE 22
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67203-3971
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-977-8400
Provider Business Practice Location Address Fax Number:
844-308-5804
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  1879 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 473095 . This is a "VALUE OPTIONS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 5591933 . This is a "FIRST HEALTH" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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