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NPI Code Detail

MEDICARE: MR. KENNETH ROMAINE HASS M.A., AAPS, LPC

MEDICARE: MR. KENNETH ROMAINE HASS M.A., AAPS, LPC
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
1101Y00000XCounselorTLPC 1020KS
2101Y00000XCounselor4088CO
3101YP2500XProfessional Counselor1868KS

General Provider Information

NPI Number : 1336254556
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KENNETH ROMAINE HASS M.A., AAPS, LPC
Provider Business Mailing Address
First Line : 5815 BROADWAY AVE
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3123
Country : US
Telephone Number : 620-792-2544
Fax Number :
Provider Business Practice Location Address
First Line : 5815 BROADWAY AVE
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3123
Country : US
Telephone Number : 620-792-2544
Fax Number : 620-792-2544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 12/04/2017

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