Healthcare Provider Details

I. General information

NPI: 1447423710
Provider Name (Legal Business Name): JOSIE I WELCH LMLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 S ROUSE ST STE C&D
PITTSBURG KS
66762-6620
US

IV. Provider business mailing address

1 MT. CARMEL WAY
PITTSBURG KS
66762
US

V. Phone/Fax

Practice location:
  • Phone: 620-231-1068
  • Fax: 620-231-2792
Mailing address:
  • Phone: 620-231-1068
  • Fax: 620-231-7602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1317
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: