Provider Demographics
NPI:1932301819
Name:HARDING, MISTY ALLYSIA (LCMFT)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:ALLYSIA
Last Name:HARDING
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:MRS
Other - First Name:MISTY
Other - Middle Name:ALLYSIA
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMFT
Mailing Address - Street 1:934 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3838
Mailing Address - Country:US
Mailing Address - Phone:316-660-7600
Mailing Address - Fax:316-941-5075
Practice Address - Street 1:940 N WACO AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3947
Practice Address - Country:US
Practice Address - Phone:316-660-7550
Practice Address - Fax:316-383-8241
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCMFT 352106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist