MEDICARE: LUCAS SHRYOCK 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
1	101YP2500X	Professional Counselor	05408	KS

General Provider Information

NPI Number	:	1629900212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCAS SHRYOCK LPC

Provider Business Mailing Address
First Line	:	2765 N BATTIN CT
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-2638
Country	:	US
Telephone Number	:	913-296-3168
Fax Number	:

Provider Business Practice Location Address
First Line	:	8080 E CENTRAL AVE STE 190
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2389
Country	:	US
Telephone Number	:	316-260-3777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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Directions to “ LUCAS SHRYOCK LPC” Practice Location

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