Provider Demographics
NPI:1972043040
Name:HUTCHINSON PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:HUTCHINSON PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AJ
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-663-4802
Mailing Address - Street 1:PO BOX 1221
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67504-1221
Mailing Address - Country:US
Mailing Address - Phone:620-663-4802
Mailing Address - Fax:620-663-9867
Practice Address - Street 1:125 W 2ND AVE STE E
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5263
Practice Address - Country:US
Practice Address - Phone:620-663-4802
Practice Address - Fax:620-663-9867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0374103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100237680AMedicaid
KS004369Medicare PIN