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200 Southwind Pl Ste 201 Manhattan KS 66503-3186 | |
| (785) 323-8632 | |
| (785) 644-0661 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 200 Southwind Pl Ste 201, Manhattan, Kansas |
| Authorized Official Name and Position | Courtney Graby (PRESIDNET) |
| Authorized Official Contact | 7853238632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
200 Southwind Pl Ste 201 Manhattan KS 66503-3186 Ph: (785) 323-8632 | 200 Southwind Pl Ste 201 Manhattan KS 66503-3186 Ph: (785) 323-8632 |
| NPI Number | 1538887120 |
|---|---|
| Provider Enumeration Date | 08/19/2022 |
| Last Update Date | 07/12/2024 |
| Certification Date | 07/12/2024 |
| Medicare PECOS PAC ID | 5890234942 |
|---|---|
| Medicare Enrollment ID | O20240903003220 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538887120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela Marie Stevens |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265150726 PECOS PAC ID: 8224577374 Enrollment ID: I20240903003292 |
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