MEDICARE: MR. STEPHEN KAMAU MA, LCAC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	618	KS

General Provider Information

NPI Number	:	1578712600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN KAMAU MA, LCAC

Provider Business Mailing Address
First Line	:	9918 E.HARRY
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67207
Country	:	US
Telephone Number	:	316-260-3445
Fax Number	:	316-260-3367

Provider Business Practice Location Address
First Line	:	9918 E HARRY ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67207-5008
Country	:	US
Telephone Number	:	316-260-3445
Fax Number	:	316-260-3367

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	07/21/2022

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