Healthcare Provider Details

I. General information

NPI: 1639001100
Provider Name (Legal Business Name): ACORNS TO OAKS PEDIATRIC PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E MAPLE ST STE 206
COLUMBUS KS
66725-1802
US

IV. Provider business mailing address

120 E MAPLE ST STE 206
COLUMBUS KS
66725-1802
US

V. Phone/Fax

Practice location:
  • Phone: 620-429-5314
  • Fax:
Mailing address:
  • Phone: 620-429-5314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA D WILLIAMS
Title or Position: OWNER
Credential:
Phone: 918-533-3956