Provider Demographics
NPI:1891271391
Name:FLINT HILLS TRAUMA THERAPY
Entity Type:Organization
Organization Name:FLINT HILLS TRAUMA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAPTIST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:785-313-6889
Mailing Address - Street 1:632 TUTTLE CREEK BLVD # 1029
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5854
Mailing Address - Country:US
Mailing Address - Phone:785-313-6889
Mailing Address - Fax:
Practice Address - Street 1:322 HOUSTON ST SUITE 103.4
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-313-6889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS353106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty