Provider Demographics
NPI:1619072477
Name:MECHLER, WALLACELL EDWARD (CADC NCAC)
Entity Type:Individual
Prefix:MR
First Name:WALLACELL
Middle Name:EDWARD
Last Name:MECHLER
Suffix:
Gender:M
Credentials:CADC NCAC
Other - Prefix:
Other - First Name:WALLY
Other - Middle Name:
Other - Last Name:MECHLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1505 SW FAIRLAWN RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-6400
Mailing Address - Country:US
Mailing Address - Phone:785-271-8614
Mailing Address - Fax:785-271-8615
Practice Address - Street 1:1505 SW FAIRLAWN RD
Practice Address - Street 2:SUITE E
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-6400
Practice Address - Country:US
Practice Address - Phone:785-271-8614
Practice Address - Fax:785-271-8615
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS427101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)