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General NPI Number Information
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NPI Number | 1952296303
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Entity Type | Organization
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Legal Business Name | SOARING EAGLES THERAPY
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 7200 W 13TH ST N
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City | WICHITA
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State | KS
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Zip | 67212-2970
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Country | US
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Telephone | 316-744-6433
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 N EMERALD CT
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City | MAIZE
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State | KS
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Zip | 67101-8717
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Country | US
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Telephone | 316-744-6433
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Fax |
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Authorized Official
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Title or Position | OWNER / THERAPIST
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Name | MR. JACOB ASBRIDGE
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Credential | LSCSW
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Telephone | 316-744-6433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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