Organization
JKC PSYCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANINE KESTERSON-CRAVENS PH.D, BCBA-D (PSYCHOLOGIST)
(918) 527-5864
Entity
Organization
Contact information
Practice address
1445 N ROCK RD STE 130, WICHITA, KS 67206-1287
(316) 847-9824
Mailing address
1445 N ROCK RD STE 130, WICHITA, KS 67206-1287
(316) 847-9824
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
04/05/2022
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