Provider Demographics
NPI:1568433555
Name:BLANCHARD, CHRISTY A (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:A
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 WAKARUSA DR STE C3C
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3910
Mailing Address - Country:US
Mailing Address - Phone:785-838-8998
Mailing Address - Fax:888-361-6910
Practice Address - Street 1:1201 WAKARUSA DR STE C3C
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3910
Practice Address - Country:US
Practice Address - Phone:785-838-8998
Practice Address - Fax:888-361-6910
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1186103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100097940AMedicaid
KS119746Medicare ID - Type Unspecified