Individual
CHAD CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMFT
Contact information
Practice address
4505 E 47TH ST S, WICHITA, KS 67210-1651
(316) 529-9100
(316) 529-9351
Mailing address
4505 E 47TH ST S, WICHITA, KS 67210-1651
(316) 529-9100
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
689
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100229020A
—
KS
01
—
829978
BCBS
KS
Enumeration date
09/27/2006
Last updated
08/23/2011
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