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General NPI Number Information
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NPI Number | 1013138957
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Entity Type | Individual
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Provider Name | JEANINE CARDER LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 4601 E DOUGLAS AVE STE 120
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City | WICHITA
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State | KS
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Zip | 67218-1032
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Country | US
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Telephone | 316-535-9894
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Fax | 316-337-5530
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Provider Business Mailing Address
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Address Line | 249 COUNTRY VIEW LN
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City | STERLING
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State | KS
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Zip | 67579-9552
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Country | US
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Telephone | 316-259-7018
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Fax | 316-373-5531
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2237
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License Number State | KS
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