| Mkc Counseling, Llc | |
|
654 N Woodchuck St Ste F Wichita KS 67212-3571 | |
| (316) 371-7226 | |
| (888) 527-4437 |
| Full Name | Mkc Counseling, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 654 N Woodchuck St Ste F, Wichita, Kansas |
| Authorized Official Name and Position | Marcia Cordes (OWNER/THERAPIST) |
| Authorized Official Contact | 3163717226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mkc Counseling, Llc 1307 N Coach House Ct Wichita KS 67235-9706 Ph: (316) 371-7226 | Mkc Counseling, Llc 654 N Woodchuck St Ste F Wichita KS 67212-3571 Ph: (316) 371-7226 |
| NPI Number | 1518476589 |
|---|---|
| Provider Enumeration Date | 09/21/2017 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 5294073722 |
|---|---|
| Medicare Enrollment ID | O20190208000137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518476589 | NPI | - | NPPES |
| 201134910A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2792 (Kansas) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 4695 (Kansas) | Secondary |
| Provider Name | Marcia D Kennedy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376999409 PECOS PAC ID: 5294091534 Enrollment ID: I20190218000989 |
| Provider Name | Marcia D Kennedy |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1376999409 PECOS PAC ID: 5294091534 Enrollment ID: I20200813001486 |
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