Provider Demographics
NPI:1619517323
Name:MUTH, INC.
Entity Type:Organization
Organization Name:MUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LPC,LCAC
Authorized Official - Phone:620-617-5497
Mailing Address - Street 1:1842 CR 370 RD
Mailing Address - Street 2:
Mailing Address - City:ALBERT
Mailing Address - State:KS
Mailing Address - Zip Code:67511
Mailing Address - Country:US
Mailing Address - Phone:620-617-5497
Mailing Address - Fax:
Practice Address - Street 1:1916 16TH ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-4001
Practice Address - Country:US
Practice Address - Phone:620-792-5405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty