| Elizabeth Layton Center, Inc. | |
|
2537 Eisenhower Rd Ottawa KS 66067-9482 | |
| (785) 242-3780 | |
| (785) 242-6397 |
| Full Name | Elizabeth Layton Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2537 Eisenhower Rd, Ottawa, Kansas |
| Authorized Official Name and Position | Leslie Bjork (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7852423780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Layton Center, Inc. 2537 Eisenhower Rd Po Box 677 Ottawa KS 66067-9482 Ph: (785) 242-3780 | Elizabeth Layton Center, Inc. 2537 Eisenhower Rd Ottawa KS 66067-9482 Ph: (785) 242-3780 |
| NPI Number | 1649296757 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/17/2016 |
| Medicare PECOS PAC ID | 1557255940 |
|---|---|
| Medicare Enrollment ID | O20040209000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649296757 | NPI | - | NPPES |
| 100097990A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 008 (Kansas) | Primary |
| Provider Name | Robin L Burgess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235162496 PECOS PAC ID: 7012985815 Enrollment ID: I20040920000865 |
| Provider Name | Diane Z Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780786533 PECOS PAC ID: 2769376169 Enrollment ID: I20050504000776 |
| Provider Name | Tamara K Canterbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255483772 PECOS PAC ID: 0345280707 Enrollment ID: I20050505000478 |
| Provider Name | Rebecca Rasmussen Miles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669416509 PECOS PAC ID: 1557396710 Enrollment ID: I20050927001195 |
| Provider Name | Gerald T Gambrill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982620019 PECOS PAC ID: 6800802612 Enrollment ID: I20060303000286 |
| Provider Name | Jennifer R Jackson-colburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497787154 PECOS PAC ID: 1759487390 Enrollment ID: I20070427000545 |
| Provider Name | Kristin Antony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972529709 PECOS PAC ID: 6406955533 Enrollment ID: I20070629000559 |
| Provider Name | Bruce M Cappo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831134238 PECOS PAC ID: 1355246638 Enrollment ID: I20080205000296 |
| Provider Name | Megan M Darling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316163512 PECOS PAC ID: 2769625110 Enrollment ID: I20130904000220 |
| Provider Name | Tracey L Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184773830 PECOS PAC ID: 3870771249 Enrollment ID: I20140514000290 |
| Provider Name | Marquetta L Sims Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134169584 PECOS PAC ID: 3870714231 Enrollment ID: I20150327001201 |
| Provider Name | Lisa S Toburen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053506717 PECOS PAC ID: 3274849773 Enrollment ID: I20150828001352 |
| Provider Name | Abbey M Hope |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1285128603 PECOS PAC ID: 7113277914 Enrollment ID: I20180828003932 |
| Provider Name | Jade M Brake |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1487149522 PECOS PAC ID: 7810247590 Enrollment ID: I20180829003650 |
| Provider Name | Kathleen A Mcgrath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780114991 PECOS PAC ID: 2062771553 Enrollment ID: I20190822000648 |
| Provider Name | Betsy Scott Teigen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952460743 PECOS PAC ID: 8022445907 Enrollment ID: I20200305002773 |
| Provider Name | Timothy Allen Post |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801905682 PECOS PAC ID: 6800868241 Enrollment ID: I20210506002895 |
| Provider Name | Jessica Fairchilds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639696743 PECOS PAC ID: 5395002729 Enrollment ID: I20210902003383 |
| Provider Name | Shirin F Bibayan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861927774 PECOS PAC ID: 3375943111 Enrollment ID: I20211105001986 |
| Provider Name | Lisa S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245462712 PECOS PAC ID: 6608058219 Enrollment ID: I20211115000832 |
| Provider Name | Katie Stegner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548646862 PECOS PAC ID: 6507227840 Enrollment ID: I20230802002100 |
| Provider Name | Matthew J Benorden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346924990 PECOS PAC ID: 3375905961 Enrollment ID: I20230814003091 |
| Provider Name | Raymona L Folsom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700219946 PECOS PAC ID: 1951734672 Enrollment ID: I20231130001462 |
| Provider Name | Thomas C Prather |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568196269 PECOS PAC ID: 7012366842 Enrollment ID: I20231205003510 |
| Provider Name | Telisa L Purdy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770728537 PECOS PAC ID: 2466801295 Enrollment ID: I20231205003581 |
| Provider Name | Blaire Hunt-lobdell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659925535 PECOS PAC ID: 7315370038 Enrollment ID: I20231212003451 |
| Provider Name | Kimberly M Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750533998 PECOS PAC ID: 8426407636 Enrollment ID: I20231213003037 |
| Provider Name | Janelle R Rowe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689354649 PECOS PAC ID: 7214386242 Enrollment ID: I20231215000513 |
| Provider Name | Abbey M Hope |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285128603 PECOS PAC ID: 7113277914 Enrollment ID: I20231215002070 |
| Provider Name | Reg A Ayres |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659398642 PECOS PAC ID: 4183518509 Enrollment ID: I20240117000183 |
| Provider Name | Nathan Gillaspie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952080137 PECOS PAC ID: 5092163196 Enrollment ID: I20240117000213 |
| Provider Name | Madison R Bryant |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568141877 PECOS PAC ID: 4284077140 Enrollment ID: I20240207002514 |
| Provider Name | Charles C Worthey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750139556 PECOS PAC ID: 3577905934 Enrollment ID: I20240530002234 |
Epiphany Counseling Centre Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1047 S Pine St, Ottawa, KS 66067 Phone: 785-242-0500 Fax: 785-242-7922 | |
Fortis, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Stubblefield Ln, Ottawa, KS 66067 Phone: 913-244-0648 Fax: 913-490-2967 | |
Elizabeth Layton Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2537 Eisenhower Rd, Ottawa, KS 66067 Phone: 785-242-3780 Fax: 785-242-6397 |