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General NPI Number Information
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NPI Number | 1043354343
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Entity Type | Individual
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Provider Name | MICHAEL JAMES LEARY M.ED., L.C.P.C.
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Gender | Male
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8020 E CENTRAL AVE SUITE 160
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City | WICHITA
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State | KS
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Zip | 67206-2360
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Country | US
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Telephone | 316-634-0029
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Fax | 316-634-0029
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Provider Business Mailing Address
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Address Line | 7233 E OXFORD ST
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City | WICHITA
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State | KS
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Zip | 67226-1716
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Country | US
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Telephone | 316-685-2922
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 121
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License Number State | KS
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