Provider Demographics
NPI:1467521732
Name:COUNSELING SERVICES OF THE PRAIRIE, LLC
Entity Type:Organization
Organization Name:COUNSELING SERVICES OF THE PRAIRIE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:WAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-973-2364
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VIEW
Mailing Address - State:KS
Mailing Address - Zip Code:67664-0006
Mailing Address - Country:US
Mailing Address - Phone:785-973-2364
Mailing Address - Fax:
Practice Address - Street 1:314 MAYBERRY LANE
Practice Address - Street 2:
Practice Address - City:PRAIRIE VIEW
Practice Address - State:KS
Practice Address - Zip Code:67664-0006
Practice Address - Country:US
Practice Address - Phone:785-973-2364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health