| Carrie Couture Lscsw Llc | |
|
2118 N Tyler Rd Building B Ste 100 Wichita KS 67212-4912 | |
| (316) 779-2564 | |
| Not Available |
| Full Name | Carrie Couture Lscsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2118 N Tyler Rd Building B Ste 100, Wichita, Kansas |
| Authorized Official Name and Position | Carrie D Couture (OWNER) |
| Authorized Official Contact | 3167792564 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carrie Couture Lscsw Llc 2118 N Tyler Rd Building B Ste 100 Wichita KS 67212-4912 Ph: (316) 779-2564 | Carrie Couture Lscsw Llc 2118 N Tyler Rd Building B Ste 100 Wichita KS 67212-4912 Ph: (316) 779-2564 |
| NPI Number | 1457127110 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/03/2023 |
| Medicare PECOS PAC ID | 8123465051 |
|---|---|
| Medicare Enrollment ID | O20240327000889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457127110 | NPI | - | NPPES |
| 3000452265004 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carrie D Couture |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780892604 PECOS PAC ID: 2961577473 Enrollment ID: I20080819000201 |
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