Organization
COUNTY OF SEDGWICK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN TAMMANY LMLP (EXECUTIVE DIRECTOR)
(316) 660-7665
Entity
Organization
Contact information
Practice address
635 N MAIN ST, WICHITA, KS 67203-3602
(316) 660-7600
(316) 660-7510
Mailing address
271 W 3RD ST N STE 600, WICHITA, KS 67202-1223
(316) 660-7600
(316) 941-5075
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006904
BCBS GROUP #
KS
05
—
100056230A
—
KS
05
—
100056230C
—
KS
05
—
100080500B
—
KS
05
—
100229160A
—
KS
05
—
100237150F
—
KS
01
—
116044
BLUE CROSS OSAF PROV #
KS
01
—
324716
VALUE OPTIONS PROV #
KS
Enumeration date
11/04/2005
Last updated
03/21/2018
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