Provider Demographics
NPI:1376743567
Name:SEVICK, GEORGE J (LCMFT)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:J
Last Name:SEVICK
Suffix:
Gender:M
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 E SOMMERHAUSER DR
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-3560
Mailing Address - Country:US
Mailing Address - Phone:316-655-0269
Mailing Address - Fax:316-330-6669
Practice Address - Street 1:9415 E HARRY ST STE 204
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5076
Practice Address - Country:US
Practice Address - Phone:316-350-7630
Practice Address - Fax:316-330-6669
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS724106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist