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General NPI Number Information
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NPI Number | 1881503795
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Entity Type | Individual
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Provider Name | MARISSA WINGERT
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Gender | Female
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 1601 W 16TH ST
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City | WELLINGTON
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State | KS
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Zip | 67152-8125
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Country | US
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Telephone | 620-326-7448
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Fax |
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Provider Business Mailing Address
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Address Line | 1526 E 13TH AVE
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City | WINFIELD
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State | KS
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Zip | 67156-4606
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Country | US
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Telephone | 620-222-4235
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LAC02039TS
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License Number State | KS
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