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NPI Code Detail

MEDICARE: CARLY WILLS LCMFT

MEDICARE: CARLY WILLS LCMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1093298028
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY WILLS LCMFT
Provider Business Mailing Address
First Line : 3500 N ROCK RD BLDG 100
Second Line :
City : WICHITA
State : KS
Zip : 67226-1328
Country : US
Telephone Number : 316-202-6004
Fax Number : 316-636-4488
Provider Business Practice Location Address
First Line : 3500 N ROCK RD BLDG 100
Second Line :
City : WICHITA
State : KS
Zip : 67226-1328
Country : US
Telephone Number : 316-202-6004
Fax Number : 316-636-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2018
Last Update Date : 03/17/2024

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Directions to “ CARLY WILLS LCMFT” Practice Location

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