Healthcare Provider Details

I. General information

NPI: 1801565536
Provider Name (Legal Business Name): CAMARO C KOCHER LONG MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 30TH AVE STE 400
HUTCHINSON KS
67502-2500
US

IV. Provider business mailing address

530 N RIDGE RD STE A
WICHITA KS
67212-6576
US

V. Phone/Fax

Practice location:
  • Phone: 620-314-2048
  • Fax:
Mailing address:
  • Phone: 316-201-4063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: