Healthcare Provider Details

I. General information

NPI: 1750067963
Provider Name (Legal Business Name): YOLONDA SUE FARRAR LMLP, LCAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 N EXPOSITION ST
WICHITA KS
67203-5902
US

IV. Provider business mailing address

1214 WAVERLY ST
WICHITA KS
67218-3530
US

V. Phone/Fax

Practice location:
  • Phone: 316-251-9600
  • Fax: 316-251-6981
Mailing address:
  • Phone: 316-737-5216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number00765
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number03165
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: