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NPI Code Detail

MEDICARE: MELISSA GOMEZ-BEYER

MEDICARE:   MELISSA  GOMEZ-BEYER
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1840729OTHERKSBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1831140466
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA GOMEZ-BEYER
Provider Business Mailing Address
First Line : 635 N MAIN ST
Second Line :
City : WICHITA
State : KS
Zip : 67203-3602
Country : US
Telephone Number : 316-660-7600
Fax Number : 316-383-7925
Provider Business Practice Location Address
First Line : 940 N WACO AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-3947
Country : US
Telephone Number : 316-660-7550
Fax Number : 316-383-8241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 07/08/2007

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Directions to “ MELISSA GOMEZ-BEYER ” Practice Location

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