Provider Demographics
NPI:1942684352
Name:TAJCHMAN, KATY NICOLE (LSCSW)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:NICOLE
Last Name:TAJCHMAN
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:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:WAMEGO
Mailing Address - State:KS
Mailing Address - Zip Code:66547-0104
Mailing Address - Country:US
Mailing Address - Phone:785-799-5666
Mailing Address - Fax:785-396-4399
Practice Address - Street 1:301 S 4TH STREET
Practice Address - Street 2:STE 200C
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-799-5666
Practice Address - Fax:785-396-4399
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9668104100000X
KS48951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker