Healthcare Provider Details

I. General information

NPI: 1609722693
Provider Name (Legal Business Name): CYCLES OF RENEWAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 SE 14TH TER
EL DORADO KS
67042-8820
US

IV. Provider business mailing address

2637 SE 14TH TER
EL DORADO KS
67042-8820
US

V. Phone/Fax

Practice location:
  • Phone: 316-650-0610
  • Fax: 316-650-0610
Mailing address:
  • Phone: 316-650-0610
  • Fax: 316-650-0610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DIANA BRASUELL
Title or Position: THERAPIST
Credential: LSCSW
Phone: 316-650-0610