| Village Lake Counseling | |
|
300 W Douglas Ave Ste 205 Wichita KS 67202-2904 | |
| (316) 284-7730 | |
| Not Available |
| Full Name | Village Lake Counseling |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 300 W Douglas Ave Ste 205, Wichita, Kansas |
| Authorized Official Name and Position | Anaidy G Claudio Rosa (THERAPIST) |
| Authorized Official Contact | 3162847730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Lake Counseling 265 W Village Lake Dr Derby KS 67037-2612 Ph: (316) 284-7730 | Village Lake Counseling 300 W Douglas Ave Ste 205 Wichita KS 67202-2904 Ph: (316) 284-7730 |
| NPI Number | 1326897067 |
|---|---|
| Provider Enumeration Date | 05/15/2024 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326897067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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