Provider Demographics
NPI:1861541476
Name:HESSONG, TANYA ELAINE (LSCSW)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:ELAINE
Last Name:HESSONG
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MS
Other - First Name:TANYA
Other - Middle Name:ELAINE
Other - Last Name:COMBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:6325 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4315
Mailing Address - Country:US
Mailing Address - Phone:913-206-2906
Mailing Address - Fax:
Practice Address - Street 1:9200 INDIAN CREEK PKWY STE 660
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2097
Practice Address - Country:US
Practice Address - Phone:913-850-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2021-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100098080COtherSED WAIVER
KS100098080AMedicaid
KS362B688Medicare ID - Type Unspecified