Provider Demographics
NPI:1255652616
Name:SOUTH CENTRAL MENTAL HEALTH COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:SOUTH CENTRAL MENTAL HEALTH COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-775-5491
Mailing Address - Street 1:520 E AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-2100
Mailing Address - Country:US
Mailing Address - Phone:316-775-5491
Mailing Address - Fax:316-775-5442
Practice Address - Street 1:2821 BROOKSIDE CT
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-2433
Practice Address - Country:US
Practice Address - Phone:316-425-0073
Practice Address - Fax:316-775-5442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7730104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty