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Organization

PERSHALL PSYCHOTHERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. STACI PERSHALL LSCSW (PSYCHOTHERAPIST)
(785) 383-1949
Entity
Organization

Contact information

Practice address
5040 SW 28TH ST, SUITE C, TOPEKA, KS 66614-2302
(785) 383-1949
Mailing address
104 SW WOODLAWN AVE, TOPEKA, KS 66606-1241
(785) 383-1949

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4594
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881033488
KS
Enumeration date
02/07/2017
Last updated
03/28/2017
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