| Jeanne Erikson Counseling And Coaching Llc | |
|
200 W Douglas Ave Ste 555 Wichita KS 67202-3007 | |
| (316) 776-2317 | |
| (833) 377-0520 |
| Full Name | Jeanne Erikson Counseling And Coaching Llc |
|---|---|
| Speciality | Counselor |
| Location | 200 W Douglas Ave Ste 555, Wichita, Kansas |
| Authorized Official Name and Position | Jeanne Erikson (OWNER/PROVIDER) |
| Authorized Official Contact | 3167768917 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeanne Erikson Counseling And Coaching Llc 200 W Douglas Ave Ste 555 Wichita KS 67202-3007 Ph: (316) 776-2317 | Jeanne Erikson Counseling And Coaching Llc 200 W Douglas Ave Ste 555 Wichita KS 67202-3007 Ph: (316) 776-2317 |
| NPI Number | 1023633898 |
|---|---|
| Provider Enumeration Date | 06/08/2020 |
| Last Update Date | 06/18/2020 |
| Certification Date | 06/18/2020 |
| Medicare PECOS PAC ID | 4688096464 |
|---|---|
| Medicare Enrollment ID | O20200624001793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023633898 | NPI | - | NPPES |
| 536-103-5 | Other | KS | LLC ID NUMBER |
| 0044759 | Medicaid | KS | |
| 1633 | Other | KS | LICENSED SPECIALIST CLINICAL SOCIAL WORKER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jeanne L Erikson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063512739 PECOS PAC ID: 1658269238 Enrollment ID: I20040305000709 |
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