Telisa L Purdy, LMLP | |
25955 W 327th St, Paola, KS 66071-4920 | |
(913) 557-9096 | |
(913) 294-9247 |
Full Name | Telisa L Purdy |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 25955 W 327th St, Paola, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770728537 | NPI | - | NPPES |
200587040A | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | LMLP 806 (Kansas) | Primary |
Entity Name | Elizabeth Layton Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649296757 PECOS PAC ID: 1557255940 Enrollment ID: O20040209000253 |
Mailing Address | Practice Location Address |
---|---|
Telisa L Purdy, LMLP Po Box 677, Ottawa, KS 66067-0677 Ph: (913) 557-9096 | Telisa L Purdy, LMLP 25955 W 327th St, Paola, KS 66071-4920 Ph: (913) 557-9096 |
Sam Mason, Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 N Hospital Dr, Paola, KS 66071 Phone: 913-294-9175 Fax: 913-294-9175 | |
Amy Wacker, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 25955 W 327th St, Paola, KS 66071 Phone: 913-557-9096 Fax: 913-294-9247 | |
Kelccey Manchester, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Lakemary Dr, Paola, KS 66071 Phone: 913-557-4000 | |
Elizabeth Waddle, Counselor Medicare: Not Enrolled in Medicare Practice Location: 25955 W 327th St, Paola, KS 66071 Phone: 913-557-9096 Fax: 913-294-9247 | |
Brittney Bonham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 907 N Pearl St Ste 6, Paola, KS 66071 Phone: 913-557-0575 | |
Leeanna K Billups, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 25955 W 327th St, Paola, KS 66071 Phone: 913-557-9096 Fax: 913-294-9247 | |
Keeley Morrow, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1501 E Peoria St, Paola, KS 66071 Phone: 913-557-4000 |