Healthcare Provider Details

I. General information

NPI: 1619510294
Provider Name (Legal Business Name): AIR CAPITAL COUNSELING & ASSESSMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 N WOODLAWN BLVD BLDG 300
WICHITA KS
67220-3960
US

IV. Provider business mailing address

2420 N WOODLAWN BLVD STE 300
WICHITA KS
67220-3960
US

V. Phone/Fax

Practice location:
  • Phone: 316-347-7157
  • Fax: 316-247-9528
Mailing address:
  • Phone: 316-347-7157
  • Fax: 316-247-9528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: HELEN GRZESKIEWICZ
Title or Position: OWNER
Credential: LCP, LCAC
Phone: 316-347-7157