Healthcare Provider Details

I. General information

NPI: 1255012050
Provider Name (Legal Business Name): BRICK BY BRICK THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E 7TH ST STE 215
HAYS KS
67601-4161
US

IV. Provider business mailing address

205 E 7TH ST STE 215
HAYS KS
67601-4161
US

V. Phone/Fax

Practice location:
  • Phone: 785-670-5017
  • Fax: 785-533-9771
Mailing address:
  • Phone: 785-670-5017
  • Fax: 785-553-9771

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: KELLI HERBERS
Title or Position: OWNER
Credential: LSCSW
Phone: 785-670-5017