Healthcare Provider Details

I. General information

NPI: 1134043326
Provider Name (Legal Business Name): PERSONAL & PHAMILY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S ROCK RD STE 100
WICHITA KS
67210-1836
US

IV. Provider business mailing address

135 N MADISON AVE
WICHITA KS
67214-4409
US

V. Phone/Fax

Practice location:
  • Phone: 316-821-5192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEVEN PHAM
Title or Position: COUNSELOR/OWNER
Credential: LPC
Phone: 316-821-5192