Healthcare Provider Details

I. General information

NPI: 1336765072
Provider Name (Legal Business Name): CHE BEHAVIORAL HEALTH SERVICES OF KANSAS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2020
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5251 W 116TH PL STE 200
LEAWOOD KS
66211-2011
US

IV. Provider business mailing address

PO BOX 70371
NEWARK NJ
07101-0096
US

V. Phone/Fax

Practice location:
  • Phone: 888-515-3834
  • Fax:
Mailing address:
  • Phone: 888-515-3834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DENNIS
Title or Position: MD
Credential: MD
Phone: 888-515-3834