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General NPI Number Information
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NPI Number | 1689616062
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Entity Type | Organization
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Legal Business Name | CHRISTIAN COUNSELING CENTER OF WICHITA, INC
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 333 GREENWOOD ST
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City | WICHITA
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State | KS
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Zip | 67211-1844
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Country | US
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Telephone | 316-264-8800
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Fax | 316-264-8809
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Provider Business Mailing Address
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Address Line | 333 GREENWOOD ST
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City | WICHITA
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State | KS
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Zip | 67211-1844
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Country | US
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Telephone | 316-264-8800
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Fax | 316-264-8809
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. MARK D. GLOVER
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Credential | LMFT
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Telephone | 316-264-8800
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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 | 622
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 219
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2271
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1957
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2526
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License Number State | KS
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Taxonomy #6
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 642
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License Number State | KS
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Taxonomy #7
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 643
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License Number State | KS
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Taxonomy #8
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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