| Greater Dayton Behavioral Health | |
|
560 S Turquoise St Wichita KS 67209-1707 | |
| (937) 765-6790 | |
| (937) 000-0000 |
| Full Name | Greater Dayton Behavioral Health |
|---|---|
| Speciality | Social Worker |
| Location | 560 S Turquoise St, Wichita, Kansas |
| Authorized Official Name and Position | Kathryn A Cole (OWNER) |
| Authorized Official Contact | 9377656790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Dayton Behavioral Health 560 S Turquoise St Wichita KS 67209-1707 Ph: (937) 765-6790 | Greater Dayton Behavioral Health 560 S Turquoise St Wichita KS 67209-1707 Ph: (937) 765-6790 |
| NPI Number | 1801350251 |
|---|---|
| Provider Enumeration Date | 01/29/2019 |
| Last Update Date | 11/22/2023 |
| Certification Date | 11/22/2023 |
| Medicare PECOS PAC ID | 6204169550 |
|---|---|
| Medicare Enrollment ID | O20190531001481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801350251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Tamara K Thorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053606152 PECOS PAC ID: 9032389366 Enrollment ID: I20110824000514 |
| Provider Name | Erica A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457570822 PECOS PAC ID: 6103181946 Enrollment ID: I20180529002547 |
| Provider Name | Kathryn Cole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871857664 PECOS PAC ID: 0749513091 Enrollment ID: I20190826003995 |
| Provider Name | Juliette M Marcello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780246801 PECOS PAC ID: 1355672460 Enrollment ID: I20191003001849 |
| Provider Name | George Andrew Darling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144839457 PECOS PAC ID: 9032534730 Enrollment ID: I20201029002125 |
| Provider Name | Janet Lee Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619510989 PECOS PAC ID: 3375979545 Enrollment ID: I20201203002109 |
| Provider Name | Chelsea Leann Birkemeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912589318 PECOS PAC ID: 8820407117 Enrollment ID: I20210622002874 |
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