MEDICARE: EARLY CHILDHOOD COLLECTIVE OF DOUGLAS COUNTY INC

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	374J00000X	Doula

General Provider Information

NPI Number	:	1457143349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARLY CHILDHOOD COLLECTIVE OF DOUGLAS COUNTY INC

Provider Business Mailing Address
First Line	:	3110 MESA WAY
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-4200
Country	:	US
Telephone Number	:	785-842-8719
Fax Number	:

Provider Business Practice Location Address
First Line	:	3110 MESA WAY
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-4200
Country	:	US
Telephone Number	:	785-842-8719
Fax Number	:

Authorized Official
Title or Position	:	DOULA PROGRAM MANAGER
Name	:	TRACI D DOTSON
Credential	:	MSW
Telephone Number	:	785-842-8719

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	10/23/2025

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