Provider Demographics
NPI:1679275150
Name:HANDY, WANDA FAYE (LCAC)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:FAYE
Last Name:HANDY
Suffix:
Gender:F
Credentials:LCAC
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:FAYE COWAN
Other - Last Name:HANDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3360 SW HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2492
Mailing Address - Country:US
Mailing Address - Phone:785-266-4100
Mailing Address - Fax:785-266-4103
Practice Address - Street 1:3360 SW HARRISON ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2492
Practice Address - Country:US
Practice Address - Phone:785-266-4100
Practice Address - Fax:785-266-4103
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS641101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)