Basic Information
Provider Information
NPI: 1306913215
EntityType: 2
ReplacementNPI:  
OrganizationName: THE CENTER FOR COUNSELING
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5815 BROADWAY
Address2:  
City: GREAT BEND
State: KS
PostalCode: 67530
CountryCode: US
TelephoneNumber: 3207922544
FaxNumber: 6207924323
Practice Location
Address1: 5815 BROADWAY
Address2:  
City: GREAT BEND
State: KS
PostalCode: 67530
CountryCode: US
TelephoneNumber: 3207922544
FaxNumber: 6207924323
Other Information
ProviderEnumerationDate: 11/29/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STANG
AuthorizedOfficialFirstName: PATRICK
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: CLINICAL DIRECTOR
AuthorizedOfficialTelephone: 6207922544
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
343900000X  Y Transportation ServicesNon-emergency Medical Transport (VAN) 

No ID Information.


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