Healthcare Provider Details

I. General information

NPI: 1962608893
Provider Name (Legal Business Name): SOUTH CENTRAL MENTAL HEALTH COUNSELING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S GORDY 3
EL DORADO KS
67042
US

IV. Provider business mailing address

120 S GORDY 3
EL DORADO KS
67042
US

V. Phone/Fax

Practice location:
  • Phone: 316-321-6088
  • Fax: 316-321-3957
Mailing address:
  • Phone: 316-321-6088
  • Fax: 316-321-3957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number024
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number024
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number024
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number024
License Number StateKS

VIII. Authorized Official

Name: MS. DEBORAH A ROMANO
Title or Position: DIRECTOR OF FINANCE & HR
Credential:
Phone: 316-321-6088