Organization
SOPHIA CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH SUE SHADDY MS, LCPC (PRESIDENT)
(913) 651-2674
Entity
Organization
Contact information
Practice address
102 OLIVE ST, LANSING, KS 66043-1639
(913) 651-2674
(866) 565-4853
Mailing address
520 SANTA FE ST, LEAVENWORTH, KS 66048-4444
(913) 651-2674
(866) 565-4853
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
358
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46082363726
—
NE
Enumeration date
06/28/2010
Last updated
06/28/2010
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