| Dbt Center Of Lawrence And Kansas City Llc | |
|
1307 Massachusetts St Lawrence KS 66044-3431 | |
| (785) 424-7770 | |
| (785) 424-7733 |
| Full Name | Dbt Center Of Lawrence And Kansas City Llc |
|---|---|
| Speciality | Counselor |
| Location | 1307 Massachusetts St, Lawrence, Kansas |
| Authorized Official Name and Position | Alyssa Duhigg (PRACTICE MANAGER) |
| Authorized Official Contact | 7854247770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dbt Center Of Lawrence And Kansas City Llc 1307 Massachusetts St Lawrence KS 66044-3431 Ph: (785) 424-7770 | Dbt Center Of Lawrence And Kansas City Llc 1307 Massachusetts St Lawrence KS 66044-3431 Ph: (785) 424-7770 |
| NPI Number | 1245717826 |
|---|---|
| Provider Enumeration Date | 07/26/2018 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 9032456397 |
|---|---|
| Medicare Enrollment ID | O20190124000233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245717826 | NPI | - | NPPES |
| 30004605360001 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2810 (Kansas) | Primary |
| Provider Name | Elizabeth W Chao |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659342541 PECOS PAC ID: 5496947418 Enrollment ID: I20101008000998 |
| Provider Name | Merrill L Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073775540 PECOS PAC ID: 6709028996 Enrollment ID: I20130819000522 |
| Provider Name | Killian James Derusha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851811756 PECOS PAC ID: 8921345752 Enrollment ID: I20221007000589 |
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