| Four County Mental Health Center Inc | |
|
3354 Highway 160 Independence KS 67301-7841 | |
| (620) 331-1748 | |
| (620) 332-1940 |
| Full Name | Four County Mental Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3354 Highway 160, Independence, Kansas |
| Authorized Official Name and Position | Greg Hennen (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6203311748 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four County Mental Health Center Inc Po Box 688 Independence KS 67301-0688 Ph: (620) 331-1748 | Four County Mental Health Center Inc 3354 Highway 160 Independence KS 67301-7841 Ph: (620) 331-1748 |
| NPI Number | 1841290251 |
|---|---|
| Provider Enumeration Date | 07/28/2005 |
| Last Update Date | 04/29/2022 |
| Certification Date | 04/29/2022 |
| Medicare PECOS PAC ID | 7012904071 |
|---|---|
| Medicare Enrollment ID | O20040430000887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841290251 | NPI | - | NPPES |
| 100097980A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Kansas) | Primary |
| Provider Name | Kurt Daniel Leis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568466043 PECOS PAC ID: 8224028931 Enrollment ID: I20040514000709 |
| Provider Name | Karen Louise Bone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568573681 PECOS PAC ID: 8729069067 Enrollment ID: I20040525000230 |
| Provider Name | Kenneth Blaine Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043311293 PECOS PAC ID: 9032184551 Enrollment ID: I20040828000229 |
| Provider Name | Danielle L Tipton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528165578 PECOS PAC ID: 2860437175 Enrollment ID: I20050627000641 |
| Provider Name | Steven Denny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881614972 PECOS PAC ID: 7810949252 Enrollment ID: I20060405000659 |
| Provider Name | Kathryn K Newman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841381894 PECOS PAC ID: 3577631498 Enrollment ID: I20081006000310 |
| Provider Name | Amy D Ford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205871613 PECOS PAC ID: 9234207168 Enrollment ID: I20081006000383 |
| Provider Name | Lynn B Holliman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639288418 PECOS PAC ID: 4981897378 Enrollment ID: I20101018000980 |
| Provider Name | Trever A Krehbiel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720284250 PECOS PAC ID: 8426245036 Enrollment ID: I20101208001111 |
| Provider Name | Terry A Goodspeed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427150309 PECOS PAC ID: 6406021104 Enrollment ID: I20111208000047 |
| Provider Name | Karla M Mcdermott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942492954 PECOS PAC ID: 3173779105 Enrollment ID: I20120808000027 |
| Provider Name | Carl L Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134157167 PECOS PAC ID: 5193960391 Enrollment ID: I20130315000464 |
| Provider Name | Linda Robinette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124565668 PECOS PAC ID: 9638446800 Enrollment ID: I20170519000764 |
| Provider Name | Indy M Fairbanks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013267756 PECOS PAC ID: 8729355573 Enrollment ID: I20170525002063 |
| Provider Name | Kelly D Bradford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386906394 PECOS PAC ID: 2769755057 Enrollment ID: I20170908000209 |
| Provider Name | Cheryl R Gore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710375050 PECOS PAC ID: 6305157645 Enrollment ID: I20180924001713 |
| Provider Name | Jennifer Ann Porrino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366700296 PECOS PAC ID: 8426301557 Enrollment ID: I20181019000175 |
| Provider Name | Patrick Harry Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124538764 PECOS PAC ID: 3577829613 Enrollment ID: I20191010000178 |
| Provider Name | Whitney L Gudgel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427596279 PECOS PAC ID: 6204248347 Enrollment ID: I20201215001927 |
| Provider Name | Meegan J Dodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083195309 PECOS PAC ID: 3779990221 Enrollment ID: I20210329001699 |
| Provider Name | Christina R Tinsley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306327572 PECOS PAC ID: 0244627685 Enrollment ID: I20220503002090 |
| Provider Name | Erin L Kaminska |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811427776 PECOS PAC ID: 8224414842 Enrollment ID: I20221005003092 |
| Provider Name | Jose Pablo Bogantes Montero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659508000 PECOS PAC ID: 2264733229 Enrollment ID: I20221214000860 |
| Provider Name | Aaron S Newton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982054292 PECOS PAC ID: 4789056128 Enrollment ID: I20230210000870 |
| Provider Name | Jessica L Haase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851090526 PECOS PAC ID: 4880068667 Enrollment ID: I20230317000476 |
| Provider Name | Mackie Yaussi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194139535 PECOS PAC ID: 7719342195 Enrollment ID: I20230509000839 |
| Provider Name | Andrea Hinkle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841785201 PECOS PAC ID: 3173972536 Enrollment ID: I20231211000832 |
| Provider Name | Serena Kill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730562414 PECOS PAC ID: 8224487301 Enrollment ID: I20231214001933 |
| Provider Name | Tammy Blaich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801992730 PECOS PAC ID: 6901257468 Enrollment ID: I20240109002045 |
| Provider Name | Ginger L Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144322959 PECOS PAC ID: 3375994890 Enrollment ID: I20240109004452 |
Connections Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3354 Highway 160, Independence, KS 67301 Phone: 620-331-1748 | |
Four County Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3354 Highway 160, Independence, KS 67301 Phone: 620-331-1748 Fax: 620-332-1940 | |
Countryside Counseling Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Morningside Dr, Independence, KS 67301 Phone: 620-577-4955 Fax: 620-577-4956 | |
Counseling Services Of Kansas, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N Penn Ave Ste 401, Independence, KS 67301 Phone: 620-331-2757 Fax: 844-877-5747 | |
Four County Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3354 Highway 160, Independence, KS 67301 Phone: 620-331-1748 Fax: 620-332-1940 | |
Think Thrive Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3925 Cr 3800, Independence, KS 67301 Phone: 636-359-4385 | |
Four County Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3354 Highway 160, Independence, KS 67301 Phone: 620-331-1748 Fax: 620-332-1940 |