Healthcare Provider Details

I. General information

NPI: 1033048111
Provider Name (Legal Business Name): BRAINWAVES & BEYOND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 W HARRY ST
WICHITA KS
67213-1450
US

IV. Provider business mailing address

3333 W HARRY ST
WICHITA KS
67213-1450
US

V. Phone/Fax

Practice location:
  • Phone: 316-655-4441
  • Fax: 316-262-3968
Mailing address:
  • Phone: 316-655-4441
  • Fax: 316-262-3968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMANDA ZLUTICKY
Title or Position: OWNER
Credential:
Phone: 316-655-4441