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Organization
GROW HEALTHCARE GROUP OF KANSAS PA
Active
Organization
GROW HEALTHCARE GROUP OF KANSAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAKE COOPER (CHIEF EXECUTIVE OFFICER)
(347) 851-1139
Entity
Organization
Contact information
Practice address
801 E DOUGLAS AVE FL 2, WICHITA, KS 67202-3548
(316) 974-3161
Mailing address
801 E DOUGLAS AVE FL 2, WICHITA, KS 67202-3548
(316) 974-3161
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/22/2022
Last updated
07/21/2026
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