Healthcare Provider Details

I. General information

NPI: 1316765324
Provider Name (Legal Business Name): KECIA ANN GUEST LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 SW JARDINE CT
TOPEKA KS
66611-1850
US

IV. Provider business mailing address

3321 SW JARDINE CT
TOPEKA KS
66611-1850
US

V. Phone/Fax

Practice location:
  • Phone: 785-408-6491
  • Fax:
Mailing address:
  • Phone: 785-408-6491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number04714
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number6267579573
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: