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809 S Patton Rd Great Bend KS 67530-4620 | |
| (620) 796-2206 | |
| (866) 288-1782 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 809 S Patton Rd, Great Bend, Kansas |
| Authorized Official Name and Position | Kelley Johnson (PRESIDENT) |
| Authorized Official Contact | 6207962206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1223 Great Bend KS 67530-1223 Ph: (620) 796-2206 | 809 S Patton Rd Great Bend KS 67530-4620 Ph: (620) 796-2206 |
| NPI Number | 1114630076 |
|---|---|
| Provider Enumeration Date | 01/05/2023 |
| Last Update Date | 04/14/2024 |
| Certification Date | 04/14/2024 |
| Medicare PECOS PAC ID | 3577003466 |
|---|---|
| Medicare Enrollment ID | O20240905004630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114630076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelley Lynn Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639296759 PECOS PAC ID: 5395285282 Enrollment ID: I20240905004666 |
| Provider Name | Marcus Herrera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629523386 PECOS PAC ID: 4880134790 Enrollment ID: I20240906000366 |
| Provider Name | Christie Lynn Kelly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942666318 PECOS PAC ID: 0446790190 Enrollment ID: I20240909001292 |
| Provider Name | Alexander M Trout |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194461343 PECOS PAC ID: 6709326143 Enrollment ID: I20240911003781 |
| Provider Name | Carolyn Stacey Farris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588120752 PECOS PAC ID: 2769923838 Enrollment ID: I20240917003886 |
| Provider Name | David Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548982945 PECOS PAC ID: 0648711051 Enrollment ID: I20240925000312 |
| Provider Name | Marilea Williams |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730875907 PECOS PAC ID: 1355873407 Enrollment ID: I20241015001932 |
Center For Counseling And Consultation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5815 Broadway Ave, Great Bend, KS 67530 Phone: 620-792-2544 Fax: 620-792-7052 | |
Mindful Healing Solutions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2008 11th St, Great Bend, KS 67530 Phone: 620-796-2788 | |
The Center For Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5815 Broadway, Great Bend, KS 67530 Phone: 620-792-2544 Fax: 620-792-4323 | |
Hhr Therapeutic Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Se 1 Ave, Great Bend, KS 67530 Phone: 620-792-5173 | |
Still Waters Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1819 11th St, Great Bend, KS 67530 Phone: 785-259-5845 Fax: 620-603-6259 |