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General NPI Number Information
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NPI Number | 1871459909
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Entity Type | Organization
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Legal Business Name | SEASONED SOUL BEHAVIORAL HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 6806 W GARDEN RIDGE CIR
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City | WICHITA
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State | KS
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Zip | 67205-1069
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Country | US
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Telephone | 316-202-5293
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Fax | 316-395-0243
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Provider Business Mailing Address
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Address Line | 6806 W GARDEN RIDGE CIR
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City | WICHITA
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State | KS
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Zip | 67205-1069
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Country | US
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Telephone | 316-202-5293
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Fax | 316-395-0243
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Authorized Official
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Title or Position | OWNER
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Name | SHARON CARPENTER
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Credential | APRN
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Telephone | 316-259-6576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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