| Psyche And Soul, Llc | |
|
650 N Carriage Pkwy Ste 125 Wichita KS 67208-4513 | |
| (316) 927-3010 | |
| Not Available |
| Full Name | Psyche And Soul, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 650 N Carriage Pkwy Ste 125, Wichita, Kansas |
| Authorized Official Name and Position | Jeremy Crosby (PSYCHOLOGIST) |
| Authorized Official Contact | 3162535107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psyche And Soul, Llc 650 N Carriage Pkwy Ste 125 Wichita KS 67208-4513 Ph: () - | Psyche And Soul, Llc 650 N Carriage Pkwy Ste 125 Wichita KS 67208-4513 Ph: (316) 927-3010 |
| NPI Number | 1639741648 |
|---|---|
| Provider Enumeration Date | 07/11/2021 |
| Last Update Date | 10/27/2021 |
| Certification Date | 10/27/2021 |
| Medicare PECOS PAC ID | 5698163533 |
|---|---|
| Medicare Enrollment ID | O20211027000321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639741648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jeremy P Crosby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003859042 PECOS PAC ID: 0446482475 Enrollment ID: I20140407000579 |
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