Provider Demographics
NPI:1114375581
Name:MCPHERSON FAMILY COUNSELING, LLC
Entity Type:Organization
Organization Name:MCPHERSON FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-212-9092
Mailing Address - Street 1:128 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LINDSBORG
Mailing Address - State:KS
Mailing Address - Zip Code:67456-2303
Mailing Address - Country:US
Mailing Address - Phone:785-212-9092
Mailing Address - Fax:
Practice Address - Street 1:200 N CARRIE ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-3775
Practice Address - Country:US
Practice Address - Phone:785-212-9092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 1416251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100007560BMedicaid
KS010870Medicare PIN