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General NPI Number Information
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NPI Number | 1841090446
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Entity Type | Organization
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Legal Business Name | COTTONWOOD ENTERPRISES
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 322 S LAURA AVE
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City | WICHITA
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State | KS
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Zip | 67211-1517
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Country | US
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Telephone | 316-260-3915
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Fax | 316-453-4173
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Provider Business Mailing Address
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Address Line | 322 S LAURA AVE
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City | WICHITA
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State | KS
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Zip | 67211-1517
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Country | US
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Telephone | 316-260-3915
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Fax | 316-453-4173
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ERIC SCHOENECKER
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Credential | LSCSW
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Telephone | 620-432-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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