Organization
TAVA CLINICAL SERVICES OF KANSAS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALLEN ALLRED (CEO)
(385) 406-2869
Entity
Organization
Contact information
Practice address
801 E DOUGLAS AVE, WICHITA, KS 67202-3548
(316) 867-9302
(801) 992-8269
Mailing address
PO BOX 581406, SALT LAKE CITY, UT 84158-1406
(385) 406-2867
(801) 992-8269
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/20/2023
Last updated
03/27/2026
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