Healthcare Provider Details

I. General information

NPI: 1972603900
Provider Name (Legal Business Name): CEDAR BRANCH RECOVERY SYSTEMS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 MASSACHUSETTS ST SUITE 118
LAWRENCE KS
66044-2345
US

IV. Provider business mailing address

1113 PRESCOTT DR
LAWRENCE KS
66049-3686
US

V. Phone/Fax

Practice location:
  • Phone: 785-840-0374
  • Fax:
Mailing address:
  • Phone: 785-840-0374
  • Fax: 785-856-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLSCSW 1804
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLSCSW 1804
License Number StateKS

VIII. Authorized Official

Name: MR. WILLIAM NELSON VIEUX
Title or Position: DIRECTOR
Credential: LSCSW
Phone: 785-840-0374