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General NPI Number Information
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NPI Number | 1063895209
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Entity Type | Organization
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Legal Business Name | LET'S TALK THERAPY AND SUPERVISION INC
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 2458 W NEWELL ST
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City | WICHITA
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State | KS
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Zip | 67203-5108
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Country | US
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Telephone | 316-691-7201
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Fax | 316-847-7082
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Provider Business Mailing Address
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Address Line | 2458 W NEWELL ST
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City | WICHITA
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State | KS
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Zip | 67203-5108
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Country | US
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Telephone | 316-691-7201
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Fax | 316-847-7082
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. ANGELA NICHOLE HOLOUBEK
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Credential | LSCSW, RPT
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Telephone | 316-691-7201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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