MEDICARE: PSYNERGY MENTAL WELLNESS 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1548157654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYNERGY MENTAL WELLNESS LLC

Provider Business Mailing Address
First Line	:	131 N SANTA FE AVE # 125
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401-2642
Country	:	US
Telephone Number	:	785-269-5054
Fax Number	:	785-203-8606

Provider Business Practice Location Address
First Line	:	131 N SANTA FE AVE # 125
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401-2642
Country	:	US
Telephone Number	:	785-269-5054
Fax Number	:	785-203-8606

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	KRISTA WISS
Credential	:	PMHNP
Telephone Number	:	785-269-5054

Provider Enumeration Date	:	06/20/2025
Last Update Date	:	11/05/2025

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