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SOUTH CENTRAL MENTAL HEALTH COUNSELING CENTER, INC.

Addiction Substance Use Disorder

El Dorado, Kansas

Provider NPI: 1538155882

Organization Information:
Organization Name:  SOUTH CENTRAL MENTAL HEALTH COUNSELING CENTER, INC.
Organization is not Subpart
Authorized Official:  DAN R RICE  EXECUTIVE DIRECTOR  316-7755491

Practice Location:
2365 W. CENTRAL  EL DORADO, KS 67042 US
Tel: 316-321-6036  Fax: 316-321-6336

Business Mailing Address:
520 E. AUGUSTA AVE.  AUGUSTA, KS 67010 US
Tel: 316-775-5491  Fax: 316-775-5442

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
KS024
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
KS024
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
KS024
N103TF0200XBehavioral Health & Social Service Providers
Psychologist
KS024
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
KS024
N106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
KS024

Other Provider Identifiers:

IssuerNumberStateType
GROUP PROVIDER NUMBER006905KS04
100097960BKS05
100097960AKS05
200001090AKS05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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