Healthcare Provider Details

I. General information

NPI: 1376215459
Provider Name (Legal Business Name): ABUNDANCE OF JOY COUNSELING SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 E DOUGLAS AVE STE 209
WICHITA KS
67218-1032
US

IV. Provider business mailing address

2250 N ROCK RD STE 118-179
WICHITA KS
67226-2331
US

V. Phone/Fax

Practice location:
  • Phone: 316-351-8113
  • Fax: 316-333-5869
Mailing address:
  • Phone: 316-351-8113
  • Fax: 316-333-5869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: CHARMETREA BELL
Title or Position: OWNER
Credential:
Phone: 785-341-5576