Provider Demographics
NPI:1881554186
Name:ORTIZ, MARY (LSCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 S CLAIRBORNE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1774
Mailing Address - Country:US
Mailing Address - Phone:913-730-3661
Mailing Address - Fax:913-768-1944
Practice Address - Street 1:407 S CLAIRBORNE RD STE 104
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1744
Practice Address - Country:US
Practice Address - Phone:913-648-2266
Practice Address - Fax:855-348-3430
Is Sole Proprietor?:No
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS068011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical