| Ict Therapy Works, Llc | |
|
545 N Woodlawn St Wichita KS 67208-3645 | |
| (316) 260-6889 | |
| (316) 928-2473 |
| Full Name | Ict Therapy Works, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 545 N Woodlawn St, Wichita, Kansas |
| Authorized Official Name and Position | Mary Rachel Pearson (OWNER) |
| Authorized Official Contact | 3162606889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ict Therapy Works, Llc 545 N Woodlawn St Wichita KS 67208-3645 Ph: (316) 260-6889 | Ict Therapy Works, Llc 545 N Woodlawn St Wichita KS 67208-3645 Ph: (316) 260-6889 |
| NPI Number | 1396102315 |
|---|---|
| Provider Enumeration Date | 01/21/2016 |
| Last Update Date | 03/28/2021 |
| Certification Date | 03/28/2021 |
| Medicare PECOS PAC ID | 6709176118 |
|---|---|
| Medicare Enrollment ID | O20160526000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396102315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Paula S Philson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649349127 PECOS PAC ID: 0143119941 Enrollment ID: I20040311000305 |
| Provider Name | Dawn S Gettman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821195975 PECOS PAC ID: 4789773433 Enrollment ID: I20071203000351 |
| Provider Name | Nancy E Trout |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417138165 PECOS PAC ID: 4587744081 Enrollment ID: I20080109000871 |
| Provider Name | Jennifer Azar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386300515 PECOS PAC ID: 5395100580 Enrollment ID: I20230421001488 |
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