Healthcare Provider Details

I. General information

NPI: 1982405346
Provider Name (Legal Business Name): STEPPING UP MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 CENTRAL AVE STE LL22
DODGE CITY KS
67801-6223
US

IV. Provider business mailing address

2601 CENTRAL AVE LL22
DODGE CITY KS
67801-8458
US

V. Phone/Fax

Practice location:
  • Phone: 620-255-9706
  • Fax:
Mailing address:
  • Phone: 620-255-9706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RACHELLE BANNING
Title or Position: ARNP
Credential: PMHNP
Phone: 620-255-9706