Provider Demographics
NPI:1093298028
Name:WILLS, CARLY (LCMFT)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:WILLS
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 N ROCK RD BLDG 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1328
Mailing Address - Country:US
Mailing Address - Phone:316-202-6004
Mailing Address - Fax:316-636-4488
Practice Address - Street 1:3500 N ROCK RD BLDG 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1328
Practice Address - Country:US
Practice Address - Phone:316-202-6004
Practice Address - Fax:316-636-4488
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist