| Goodheart Psychology, Llc | |
|
940 N Tyler Rd Ste 209 Wichita KS 67212-3265 | |
| (785) 623-0303 | |
| Not Available |
| Full Name | Goodheart Psychology, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 940 N Tyler Rd Ste 209, Wichita, Kansas |
| Authorized Official Name and Position | Kristin L Goodheart (LICENSED PSYCHOLOGIST, OPERATOR) |
| Authorized Official Contact | 7856230303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodheart Psychology, Llc 8918 W 21st St N Ste 200 #215 Wichita KS 67205-2124 Ph: () - | Goodheart Psychology, Llc 940 N Tyler Rd Ste 209 Wichita KS 67212-3265 Ph: (785) 623-0303 |
| NPI Number | 1023508652 |
|---|---|
| Provider Enumeration Date | 05/18/2018 |
| Last Update Date | 05/18/2018 |
| Medicare PECOS PAC ID | 3779838925 |
|---|---|
| Medicare Enrollment ID | O20180612002528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023508652 | NPI | - | NPPES |
| 200589950A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2180 (Kansas) | Primary |
| Provider Name | Kristin L Goodheart |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144581489 PECOS PAC ID: 2769610450 Enrollment ID: I20131231000832 |
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