Provider Demographics
NPI:1376428243
Name:VAN ZELFDEN, KATHY
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:VAN ZELFDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 N OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-2106
Mailing Address - Country:US
Mailing Address - Phone:316-267-5437
Mailing Address - Fax:
Practice Address - Street 1:2258 N LAKEWAY CIR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1082
Practice Address - Country:US
Practice Address - Phone:316-945-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3081104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker