Healthcare Provider Details

I. General information

NPI: 1962619296
Provider Name (Legal Business Name): KATIE M RAGAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31ST MEDICAL GROUP/SGST UNIT 6180
APO AE
09604
US

IV. Provider business mailing address

5245 NW ARROYO DR
TOPEKA KS
66618-3139
US

V. Phone/Fax

Practice location:
  • Phone: 43-430-5459
  • Fax:
Mailing address:
  • Phone: 785-251-3306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY60163183
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY60163183
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY60163183
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number03328
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: