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Organization
SOUTHEAST KANSAS MENTAL HEALTH CENTER
Active
Organization
SOUTHEAST KANSAS MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA BENNETT (DIRECTOR OF OFFICE OPERATIONS)
(620) 365-8641
Entity
Organization
Contact information
Practice address
1106 S 9TH ST, HUMBOLDT, KS 66748-1934
(620) 473-2241
(620) 473-3334
Mailing address
1106 S 9TH ST, HUMBOLDT, KS 66748-1934
(620) 473-2241
(620) 473-3334
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
025
KS
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006901
BLUE SHIELD
KS
05
—
3000391474
—
KS
Enumeration date
04/03/2006
Last updated
03/20/2026
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