Organization
SUNFLOWER PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY W BASE LCP (CHIEF EXECUTIVE OFFICER)
(316) 201-3125
Entity
Organization
Contact information
Practice address
209 E WILLIAM ST STE 535, WICHITA, KS 67202-4015
(316) 201-3125
Mailing address
209 E WILLIAM ST STE 535, WICHITA, KS 67202-4015
(316) 201-3125
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2623
KS
101YP2500X
Professional Counselor
2740
KS
103T00000X
Psychologist
2445
KS
103T00000X
Psychologist
2609
KS
103TC0700X
Clinical Psychologist
Primary
1465
KS
103TC0700X
Clinical Psychologist
248
KS
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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