| Ict Hope Therapy Center, Llc | |
|
9415 E Harry St Ste 208 Wichita KS 67207-5076 | |
| (316) 573-7343 | |
| (316) 221-7159 |
| Full Name | Ict Hope Therapy Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 9415 E Harry St Ste 208, Wichita, Kansas |
| Authorized Official Name and Position | Heather Ann Spencer (OWNER/THERAPIST) |
| Authorized Official Contact | 3165737343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ict Hope Therapy Center, Llc 9415 E Harry St Ste 503 Wichita KS 67207-5082 Ph: (316) 573-7343 | Ict Hope Therapy Center, Llc 9415 E Harry St Ste 208 Wichita KS 67207-5076 Ph: (316) 573-7343 |
| NPI Number | 1710644422 |
|---|---|
| Provider Enumeration Date | 11/17/2021 |
| Last Update Date | 03/02/2022 |
| Certification Date | 03/02/2022 |
| Medicare PECOS PAC ID | 4284027137 |
|---|---|
| Medicare Enrollment ID | O20220217000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710644422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Heather A Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710282801 PECOS PAC ID: 0547599300 Enrollment ID: I20190904002984 |
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