| Inspire Counseling And Support Center, Inc | |
|
820 N Main St Wichita KS 67203-3605 | |
| (316) 202-7051 | |
| (833) 213-7988 |
| Full Name | Inspire Counseling And Support Center, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 820 N Main St, Wichita, Kansas |
| Authorized Official Name and Position | Jennifer Dellasanta (COO) |
| Authorized Official Contact | 7742532575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inspire Counseling And Support Center, Inc 3800 5th St Saint Cloud FL 34769-2024 Ph: () - | Inspire Counseling And Support Center, Inc 820 N Main St Wichita KS 67203-3605 Ph: (316) 202-7051 |
| NPI Number | 1003432683 |
|---|---|
| Provider Enumeration Date | 06/19/2020 |
| Last Update Date | 05/18/2023 |
| Certification Date | 05/18/2023 |
| Medicare PECOS PAC ID | 2961815568 |
|---|---|
| Medicare Enrollment ID | O20201228001103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003432683 | NPI | - | NPPES |
| 30004740460002 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Todd William Hollibush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780184168 PECOS PAC ID: 3173870755 Enrollment ID: I20201228001193 |
| Provider Name | Kimberly Quigley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619041803 PECOS PAC ID: 9638189442 Enrollment ID: I20201228001305 |
| Provider Name | Abigail K Shinkle |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700434818 PECOS PAC ID: 3072962315 Enrollment ID: I20231212000524 |
| Provider Name | Scarlett Bunyard |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437410610 PECOS PAC ID: 2466805247 Enrollment ID: I20240129000801 |
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