Healthcare Provider Details

I. General information

NPI: 1841052057
Provider Name (Legal Business Name): BROUS PROFESSIONAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 HALL ST STE 5
HAYS KS
67601-1964
US

IV. Provider business mailing address

2703 HALL ST STE 5
HAYS KS
67601-1964
US

V. Phone/Fax

Practice location:
  • Phone: 785-269-1011
  • Fax: 785-329-4512
Mailing address:
  • Phone: 785-269-1011
  • Fax: 785-203-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW BROUS
Title or Position: OWNER/ THERAPIST
Credential: LCPC, LCAC
Phone: 785-269-1011