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Organization

WSU PSYCHOLOGY CLINIC

Active
Parent organization
WICHITA STATE UNIVERSITY
Organization subpart
Yes

Provider details

NPI number
Legal business name
WICHITA STATE UNIVERSITY
Authorized official
BRYCE SUMMERS PH.D. (LP CLINIC DIRECTOR)
(316) 978-3170
Entity
Organization

Contact information

Practice address
DEPARTMENT OF PSYCHOLOGY-WSU PSYCHOLOGY CLINIC, 1845 FAIRMOUNT STREET, JABARA HALL, WICHITA, KS 67260
(316) 978-3170
(316) 978-3086
Mailing address
DEPARTMENT OF PSYCHOLOGY-WSU PSYCHOLOGY CLINIC, 1845 FAIRMOUNT ST, JABARA HALL CAMPUS BOX 34, WICHITA, KS 67260
(316) 978-3170
(316) 978-3086

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
103TM1800X
Intellectual & Developmental Disabilities Psychologist

Other

Enumeration date
03/13/2023
Last updated
03/13/2023
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