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General NPI Number Information
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NPI Number | 1851118095
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Entity Type | Individual
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Provider Name | CONCHANTA GUINES
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Gender | Female
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 825 N WACO AVE
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City | WICHITA
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State | KS
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Zip | 67203-3939
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Country | US
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Telephone | 316-201-6047
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Fax |
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Provider Business Mailing Address
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Address Line | 4663 WELTON ST
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City | GREENWOOD
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State | IN
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Zip | 46143-8974
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Country | US
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Telephone | 217-766-6064
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Fax |
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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 | 101Y00000X
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Taxonomy Name | 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 | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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