MEDICARE: COPPER VALLEY INTEGRATED HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1093672586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COPPER VALLEY INTEGRATED HEALTH LLC

Provider Business Mailing Address
First Line	:	423 N MCLEAN BLVD STE 301
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67203-5964
Country	:	US
Telephone Number	:	316-688-2007
Fax Number	:	316-661-1208

Provider Business Practice Location Address
First Line	:	1212 W 3RD ST N STE T1
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67203-5939
Country	:	US
Telephone Number	:	316-688-2007
Fax Number	:	316-661-1208

Authorized Official
Title or Position	:	MANAGER
Name	:	LUC-ARMAND NINGUMIRIZE
Credential	:
Telephone Number	:	207-409-4027

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	02/05/2026

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Directions to “COPPER VALLEY INTEGRATED HEALTH LLC ” Practice Location

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