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General NPI Number Information
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NPI Number | 1255652616
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL MENTAL HEALTH COUNSELING CENTER, INC.
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 2821 BROOKSIDE CT
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City | AUGUSTA
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State | KS
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Zip | 67010-2433
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Country | US
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Telephone | 316-425-0073
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Fax | 316-775-5442
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Provider Business Mailing Address
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Address Line | 520 E AUGUSTA AVE
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City | AUGUSTA
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State | KS
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Zip | 67010-2100
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Country | US
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Telephone | 316-775-5491
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Fax | 316-775-5442
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Authorized Official
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Title or Position | HR MANAGER
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Name | JUDY LOWMASTER
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Credential |
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Telephone | 316-775-5491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7730
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License Number State | KS
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