Healthcare Provider Details

I. General information

NPI: 1679569792
Provider Name (Legal Business Name): CENTER FOR HUMAN DEVELOPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E CENTRAL AVE SUITE 4
WICHITA KS
67214-4608
US

IV. Provider business mailing address

2601 E CENTRAL AVE SUITE 4
WICHITA KS
67214-4608
US

V. Phone/Fax

Practice location:
  • Phone: 316-683-2300
  • Fax: 316-683-7921
Mailing address:
  • Phone: 316-683-2300
  • Fax: 316-683-7921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP-0594
License Number StateKS

VIII. Authorized Official

Name: DR. KERIN L SCHELL
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 316-683-2300