Healthcare Provider Details

I. General information

NPI: 1396731626
Provider Name (Legal Business Name): STATE OF KANSAS - ACCOUNTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 SUNNYSIDE AVENUE 2101 HAWORTH HALL
LAWRENCE KS
66045-7534
US

IV. Provider business mailing address

1200 SUNNYSIDE AVE 2101 HAWORTH HALL
LAWRENCE KS
66045-7534
US

V. Phone/Fax

Practice location:
  • Phone: 785-864-4690
  • Fax: 785-864-5094
Mailing address:
  • Phone: 785-864-4690
  • Fax: 785-864-5094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1158
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number00123
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number00233
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number02138
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number02157
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01870
License Number StateKS
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number00953
License Number StateKS
# 8
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number02297
License Number StateKS

VIII. Authorized Official

Name: PROF. WILLIAM MATT GILLISPIE
Title or Position: CLINIC DIRECTOR
Credential: PH.D.
Phone: 785-864-4690