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NPI Code Detail

MEDICARE: BEHAVIORAL HEALTH CENTER

MEDICARE: BEHAVIORAL HEALTH CENTER
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
1251K00000XPublic Health or Welfare Agency050KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1116065OTHERKSBCBS

General Provider Information

NPI Number : 1427051242
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVIORAL HEALTH CENTER
Provider Business Mailing Address
First Line : 714 S HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67211-3002
Country : US
Telephone Number : 316-660-7411
Fax Number : 316-651-5901
Provider Business Practice Location Address
First Line : 714 S HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67211-3002
Country : US
Telephone Number : 316-660-7411
Fax Number : 316-651-5901
Authorized Official
Title or Position : PROGRAM MANAGER
Name : MS. ADRIENNE BYRNE-LUTZ
Credential : MS RAODAC
Telephone Number : 316-660-7411
Provider Enumeration Date : 05/24/2005
Last Update Date : 08/22/2020

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1851736607 — JENNIFER K MACKEY LMSW, LAC
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1972926558 — MS. DEAH MILLER LMSW, LCAC
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Directions to “BEHAVIORAL HEALTH CENTER ” Practice Location

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