Provider Demographics
NPI:1740204403
Name:ADRIAN, VELVET (LCMFT)
Entity Type:Individual
Prefix:MS
First Name:VELVET
Middle Name:
Last Name:ADRIAN
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-1844
Mailing Address - Country:US
Mailing Address - Phone:316-264-8800
Mailing Address - Fax:316-264-8809
Practice Address - Street 1:333 S GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-1844
Practice Address - Country:US
Practice Address - Phone:316-264-8800
Practice Address - Fax:316-264-8809
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS219106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist