MEDICARE: HUMPHREY COUNSELING PA

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	101YM0800X	Mental Health Counselor	74446	KS

General Provider Information

NPI Number	:	1881800860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMPHREY COUNSELING PA

Provider Business Mailing Address
First Line	:	1024 BURKE ST
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-2414
Country	:	US
Telephone Number	:	620-223-0388
Fax Number	:	620-223-3474

Provider Business Practice Location Address
First Line	:	1024 BURKE ST
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-2414
Country	:	US
Telephone Number	:	620-223-0388
Fax Number	:	620-223-3474

Authorized Official
Title or Position	:	COUNSELOR
Name	:	MRS. MARGARET ELLEN HUMPHREY
Credential	:	ARNP
Telephone Number	:	620-223-0388

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

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