Organization
COUNSELING AND MEDIATION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL NICHOLS LSCSW (EXECUTIVE DIRECTOR)
(316) 269-2322
Entity
Organization
Contact information
Practice address
210 SOULE ST, SUITE 106, DODGE CITY, KS 67801-2558
(620) 227-2503
(620) 227-9905
Mailing address
200 W DOUGLAS AVE, SUITE 560, WICHITA, KS 67202-3013
(316) 269-2322
(316) 269-2448
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
T-LPC 2790
KS
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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