Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker | |
Marriage & Family Therapist |
106H00000X | |||
Professional |
101YP2500X |
| NPI # | 1689616062 |
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| LBN Legal business name | CHRISTIAN COUNSELING CENTER OF WICHITA, INC | ||||||||||||||||||||||||||||
| Authorized official | MARK GLOVER - (CLINICAL DIRECTOR) | ||||||||||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||||||||||
| Enumeration date | 06/12/2006 | ||||||||||||||||||||||||||||
| Last updated | 09/11/2025 - About 9 months ago | ||||||||||||||||||||||||||||
| Identifiers |
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