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General NPI Number Information
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NPI Number | 1376743567
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Entity Type | Individual
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Provider Name | GEORGE J SEVICK LCMFT
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Gender | Male
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 06/19/2021
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Provider Practice Location Address
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Address Line | 9415 E HARRY ST STE 204
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City | WICHITA
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State | KS
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Zip | 67207-5076
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Country | US
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Telephone | 316-350-7630
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Fax | 316-330-6669
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Provider Business Mailing Address
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Address Line | 2119 E SOMMERHAUSER DR
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City | DERBY
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State | KS
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Zip | 67037-3560
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Country | US
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Telephone | 316-655-0269
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Fax | 316-330-6669
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 724
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License Number State | KS
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