Healthcare Provider Details

I. General information

NPI: 1851256531
Provider Name (Legal Business Name): PSYCH CREDENTIALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W DOUGLAS AVE STE 250
WICHITA KS
67202-2918
US

IV. Provider business mailing address

300 W DOUGLAS AVE STE 250
WICHITA KS
67202-2918
US

V. Phone/Fax

Practice location:
  • Phone: 316-803-2535
  • Fax:
Mailing address:
  • Phone: 316-803-2535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM S LAUDICK
Title or Position: BILLING SPECIALIST
Credential:
Phone: 316-803-2535